title: Prevalence and risk factors of carotid vessel wall inflammation in coronary artery disease patients: FDG-PET and CT imaging study.
abstract: OBJECTIVE
  We investigated the prevalence and clinical risk factors of carotid vessel wall inflammation by means of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in a population consisting of coronary artery disease (CAD) patients.
  
  
  BACKGROUND
  The atherosclerotic disease process is characterized by infiltration and retention of oxidized lipids in the artery wall, triggering a disproportionate inflammatory response. Efforts have been made to use noninvasive imaging to quantify this inflammatory response in the vessel wall. Recently, carotid FDG-PET has been shown to reflect the metabolic rate of glucose, a process known to be enhanced in inflamed tissue.
  
  
  METHODS
  Carotid inflammation was quantified in 82 CAD patients (age 62 ± 10 years) as the maximum target-to-background ratio ((wholevessel)TBR(max)). Furthermore, we assessed the maximal standardized uptake value values ((wholevessel)SUV(max)), the single hottest segment (SHS), and the percent active segments (PAS) of the FDG uptake in the artery wall, measured by FDG-PET.
  
  
  RESULTS
  Whole-vessel TBR(max) >1.8 was present in 67%, >2.0 in 39%, >2.2 in 23%, and >2.4 in 12% of the population. Multiple linear regression analysis with backward elimination revealed that body mass index (BMI) ≥30 kg/m2 (p < 0.0001), age >65 years (p = 0.01), smoking (p = 0.02), and hypertension (p = 0.01) were associated with (wholevessel)TBR(max). The number of components of the metabolic syndrome was also associated with (wholevessel)TBR(max) (p = 0.02). In similar analyses, (wholevessel)SUV(max) was associated with BMI ≥30 kg/m2 (p < 0.0001), age >65 years (p = 0.004), male gender (p = 0.02), and hypertension (p = 0.04); SHS with BMI ≥30 kg/m2 (p < 0.0001), age >65 years (p = 0.02), smoking (p = 0.04), and hypertension (p = 0.05); PAS with BMI ≥30 kg/m2 (p = 0.001), smoking (p = 0.03), and hypertension (p = 0.01).
  
  
  CONCLUSIONS
  Carotid inflammation as revealed by FDG-PET is highly prevalent in the CAD population and is associated with obesity, age over 65 years, history of hypertension, smoking, and male gender. Artery wall FDG uptake increased when components of the metabolic syndrome clustered.
authors.affiliation: Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, New York 10029, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Bucerius
authors.forename: Raphaël
authors.initials: R
authors.lastname: Duivenvoorden
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Mani
authors.forename: Colin
authors.initials: C
authors.lastname: Moncrieff
authors.forename: James H F
authors.initials: JH
authors.lastname: Rudd
authors.forename: Claudia
authors.initials: C
authors.lastname: Calcagno
authors.forename: Josef
authors.initials: J
authors.lastname: Machac
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009519:New York City / Q000453:epidemiology; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D015995:Prevalence; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
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