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New test allows doctors to predict the risk of death in people with atherosclerosis and thus prevent heart attacks.
A non-invasive imaging method for detecting progression of coronary disease in patients with myocardial infarction did not predict the primary endpoint of all coronary events, but it predicted all-cause mortality and cardiac death or nonfatal myocardial infarction.
These are the conclusions of a recent study presented at the 2022 annual conference of the European Society of Cardiology.
New studies
The PRE18FFIR study was also the first multicenter international study that prospectively investigated whether non-invasive assessment of progression of coronary atherosclerotic plaque can predict the occurrence of recurrent cardiac events in patients with myocardial infarction.
Currently, assessment is performed using clinical risk scores and evaluation of obstructive coronary disease, but with limited accuracy.
However, high-risk coronary plaques detected by invasive imaging methods are associated with future coronary events, but these techniques are impractical for widespread clinical use.
Research and heart attack outcomes
The study enrolled 704 patients aged 50 years and older between 2015 and 2020 with recent (within 21 days) myocardial infarction and multivessel coronary disease at the time of interventional coronary angiography or prior coronary revascularization. Their mean age was 64 years and 85% were men. Approximately 89% of patients had multivessel ischemic heart disease, 7% had left main disease and 4% had single-vessel disease.
All participants underwent non-invasive positron emission tomography (PET) with 18F-sodium fluoride and computed tomography coronary angiography (CTCA), and plaque activity (CMA) was measured in an independent laboratory.
Zero CMA indicates low activity of atherosclerotic plaque in the coronary vessels and CMA>0 indicates high activity of atherosclerotic plaque in the coronary vessels. In total, 421 patients had CMA>0 and 283 patients had CMA=0.
On four-year follow-up the composite primary endpoint of cardiac death, nonfatal myocardial infarction or unplanned coronary revascularization was observed in 51 patients (18%) in the CMA=0 group and in 90 patients (21%) in the CMA>0 group.
Increased coronary atherosclerotic plaque activity was not associated with the primary endpoint.
In secondary analyses increased activity of coronary atherosclerotic plaques was associated with mortality and with the primary endpoint of cardiac death or nonfatal myocardial infarction.
Source: newsitamea.gr
