18F-sodium fluoride (18F-NaF) coronary positron emission tomography (PET) may help predict the development of myocardial infarction (MI) in patients with advanced coronary artery disease (CAD), according to study results intended to be presented at the annual meeting of the American College of Cardiology (ACC.20).

According to researchers, there is a lack of tools to assess the risk of developing MI in individuals with established CAD. However, as 18F-NaF PET allows to evaluate the extent of coronary atherosclerosis, this technique may be useful in this patient population. In this study, 293 patients with established CAD (mean age, 65±9 years; 84% men) who were given 18F-NaF PET were followed for a period of 42 months to assess the occurrence of fatal or nonfatal MI. 

In this cohort, 203 patients (69%) had increased coronary 18F-NaF activity (ie, coronary microcalcification activity [CMA] >0). Only patients with CMA >0 experienced a fatal or nonfatal MI (9.9% vs 0%, respectively; P <.001). The area under the receiver operating characteristics curve for the prediction of MI was found to be higher for 18F-NaF CMA than for all other clinical predictors that were assessed (eg, computed tomography coronary calcium scores). An 8-fold increase in MI was observed in patients with CMA >1.56 (hazard ratio, 8.1; 95% CI, 2.6-25.3; P <.001) independent of factors and demographics including age, gender, and multivessel disease.

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18F-NaF coronary PET is a powerful prognostic technique to predict MI in patients with advanced established coronary artery disease,” concluded the study authors.


Kwiecinski J, Tzolos E, Cadet S, et al. 18F-sodium fluoride coronary uptake predicts myocardial infarctions in patients with known coronary artery disease. Intended to be presented at: American College of Cardiology’s 69th Annual Scientific Session; March 28-30, 2020; Chicago, IL. Presentation 916-08.