title: In-111 polyclonal HIG identifies patients but not atherosclerotic lesions at risk - a 5 years follow-up.
abstract: There is a strong need for non-invasive detection of human atherosclerotic lesions. One of the radioisotopic approaches using Indium-111-HIG has been shown to accumulate in oxidized LDL-rich foam cells and inflammatory vascular lesions. Earlier human studies in 200 patients, 100 with peripheral vascular disease and 100 with carotid artery disease comparing In-111-HIG scintigraphy with sonographic data revealed a high sensitivity (70%-77%) but a very low specificity (33%-41%). At this time we concluded the approach "not promising" for human studies. However, clinical follow-up over 5 years now shows that those patients with positive In-111-HIG scintigraphy exhibited a significantly higher vascular morbidity (P<0,01) and mortality (P<0,01), especially in the immediate follow-up period. Retrospective analysis discovered higher CRP and isoprostane (8-epi-prostaglandin (PG) F2α) levels in HIG-positive patients at the time of scintigraphy. These findings indicate that In-111-HIG reflecting vascular lesions with a high inflammatory component, probably more prone to rupture, may identify a population at high vascular risk rather than a lesion at risk. The clinical impact of this finding should be assessed in prospective studies.
authors.affiliation: HerzReha Bad Ischl, Center for Cardiovascular Rehabilitation, Bad Ischl, Austria. helmut.sinzinger@meduniwien.ac.at.
authors.forename: Robert
authors.initials: R
authors.lastname: Berent
authors.forename: Johann
authors.initials: J
authors.lastname: Auer
authors.forename: Susanne
authors.initials: S
authors.lastname: Granegger
authors.forename: Helmut
authors.initials: H
authors.lastname: Sinzinger