Clinical implication of ¹⁸F-NaF PET/computed tomography indexes of aortic calcification in coronary artery disease patients: correlations with cardiovascular risk factors

Abstract

Objective 

Vascular calcification is known to be associated with cardiovascular risk factors. Recently, ¹⁸F-NaF PET has been reported to be effective for detecting early and active vascular calcification. In this study, correlations between ¹⁸F-NaF PET/computed tomography (CT) findings and cardiovascular risk factors were investigated in patients with suspected coronary artery disease.

Patients and methods 

Forty patients with suspected coronary artery disease underwent ¹⁸F-NaF PET/CT. The maximum and overall burden of calcifying activity, and the overall burden of calcium deposition in the descending thoracic aorta (DTA) were measured on ¹⁸F-NaF PET/CT and they were compared with cardiovascular risk factors, particularly, with those related to metabolic syndrome.

Results 

The maximum and overall burden of calcifying activity in DTA measured on ¹⁸F-NaF PET were significantly correlated with diabetes mellitus (P = 0.030 and 0.049, respectively) and serum HbA1c level (ρ = 0.433 and 0.344, respectively). In contrast, the overall burden of calcium deposition measured on CT was significantly correlated with hypertension (P < 0.001). The overall burden of calcium deposition was also significantly correlated with metabolic syndrome (P = 0.002) and 10-year cardiovascular disease risk score (P = 0.004)

Conclusion 

¹⁸F-NaF uptake is closely related to diabetes mellitus, whereas aortic calcification on CT is closely related to hypertension. Although ¹⁸F-NaF uptake in DTA can be a potential prognostic factor, aortic calcification on CT is a more significant prognostic factor for overall cardiovascular risk than ¹⁸F-NaF uptake.