Carotid Plaque Inflammation Imaged by F-18-Fluorodeoxyglucose Positron Emission Tomography and Risk of Early Recurrent Stroke

Autor: Kelly, PJ, Camps-Renom, P, Giannotti, N, Marti-Fabregas, J, Murphy, S, McNulty, J, Barry, M, Barry, P, Calvet, D, Coutts, SB, Cronin, S, Delgado-Mederos, R, Dolan, E, Fernandez-Leon, A, Foley, S, Harbison, J, Horgan, G, Kavanagh, E, Marnane, M, McDonnell, C, O'Donohoe, M, Sharma, V, Walsh, C, Williams, D, O'Connell, M
Rok vydání: 2019
Předmět:
Zdroj: STROKE
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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ISSN: 0039-2499
Popis: Background and Purpose- Plaque inflammation contributes to stroke and coronary events. F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) identifies plaque inflammation-related metabolism. Almost no prospective data exist on the relationship of carotid F-18-FDG uptake and early recurrent stroke. Methods- We did a multicenter prospective cohort study BIOVASC (Biomarkers/Imaging Vulnerable Atherosclerosis in Symptomatic Carotid disease) of patients with carotid stenosis and recent stroke/transient ischemic attack with 90-day follow-up. On coregistered carotid F-18-FDG PET/computed tomography angiography, F-18-FDG uptake was expressed as maximum standardized uptake value (SUVmax) in the axial single hottest slice. We then conducted a systematic review of similar studies and pooled unpublished individual-patient data with 2 highly similar independent studies (Dublin and Barcelona). We analyzed the association of SUVmax with all recurrent nonprocedural stroke (before and after PET) and with recurrent stroke after PET only. Results- In BIOVASC (n=109, 14 recurrent strokes), after adjustment (for age, sex, stenosis severity, antiplatelets, statins, diabetes mellitus, hypertension, and smoking), the hazard ratio for recurrent stroke per 1 g/mL SUVmax was 2.2 (CI, 1.1-4.5; P=0.025). Findings were consistent in the independent Dublin (n=52, hazard ratio, 2.2; CI, 1.1-4.3) and Barcelona studies (n=35, hazard ratio, 2.8; CI, 0.98-5.5). In the pooled cohort (n=196), 37 recurrent strokes occurred (29 before and 8 after PET). Plaque SUVmax was higher in patients with all recurrence (P
Databáze: OpenAIRE
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