Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

Autor: Alex T. Vesey, Nicholas L. Mills, Neal G. Uren, Teng Y. Hoo, Nikhil Joshi, Alison Fletcher, James H.F. Rudd, Iqbal S Toor, William Jenkins, Anoop S V Shah, Andrew Sills, Edwin J R van Beek, Adam J. Melville, Sarah P. Langlands, David E. Newby, Shirjel Alam, Kathryn F. Carruthers, Keith A.A. Fox, Marc R. Dweck
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
Time Factors
Myocardial Infarction
Coronary Artery Disease
Kaplan-Meier Estimate
medicine.disease_cause
Multimodal Imaging
Coronary artery disease
Recurrence
Risk Factors
Myocardial infarction
Prospective Studies
Registries
Prospective cohort study
Original Research
biology
Middle Aged
Plaque
Atherosclerotic
Troponin
C-Reactive Protein
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
18F-fluorodeoxyglucose positron emission and computed tomography
Inflammation
Fluorodeoxyglucose F18
Predictive Value of Tests
Internal medicine
medicine
Humans
Aortitis
Aged
business.industry
C-reactive protein
medicine.disease
Atherosclerosis
Vulnerable plaque
Logistic Models
Scotland
inflammation
Positron-Emission Tomography
Multivariate Analysis
biology.protein
vulnerable plaque
Radiopharmaceuticals
business
Tomography
X-Ray Computed
Biomarkers
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Joshi, N V, Toor, I, Shah, A S V, Carruthers, K, Vesey, A T, Alam, S R, Sills, A, Hoo, T Y, Melville, A J, Langlands, S P, Jenkins, W S A, Uren, N G, Mills, N L, Fletcher, A M, van Beek, E J R, Rudd, J H F, Fox, K A A, Dweck, M R & Newby, D E 2015, ' Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction : Myocardial Infarction Begets Myocardial Infarction ', Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease, vol. 4, no. 9, pp. e001956 . https://doi.org/10.1161/JAHA.115.001956
ISSN: 2047-9980
DOI: 10.1161/JAHA.115.001956
Popis: Background Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans. Methods and Results Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F‐fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonvascular tissue (paraspinal muscle). In 1003 patients enrolled in the Global Registry of Acute Coronary Events, we assessed whether infarct size predicted early (≤30 days) and late (>30 days) recurrent coronary events. Compared with patients with stable angina, patients with MI had higher aortic 18F‐fluorodeoxyglucose uptake (tissue‐to‐background ratio 2.15±0.30 versus 1.84±0.18, P P =0.0005) despite having similar aortic ( P =0.12) and less coronary ( P =0.006) atherosclerotic burden and similar paraspinal muscular 18F‐fluorodeoxyglucose uptake ( P =0.52). Patients with ST ‐segment elevation MI had larger infarcts (peak plasma troponin 32 300 [10 200 to >50 000] versus 3800 [1000 to 9200] ng/L, P P =0.03) than those with non– ST ‐segment elevation MI. Peak plasma troponin concentrations correlated with aortic 18F‐fluorodeoxyglucose uptake ( r =0.43, P =0.01) and, on multivariate analysis, independently predicted early (tertile 3 versus tertile 1: relative risk 4.40 [95% CI 1.90 to 10.19], P =0.001), but not late, recurrent MI. Conclusions The presence and extent of MI is associated with increased aortic atherosclerotic inflammation and early recurrent MI. This finding supports the hypothesis that acute MI exacerbates systemic atherosclerotic inflammation and remote plaque destabilization: MI begets MI. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT01749254.
Databáze: OpenAIRE
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