Prognostic value of cardiac inflammation in ST-segment elevation myocardial infarction: A ¹⁸F-fluorodeoxyglucose PET/CT study

Background: ¹⁸F-fluorodeoxyglucose (FDG) imaging is used to detect cardiac inflammation and predict functional outcome in acute myocardial infarction (MI). However, data on the correlation of post-MI acute cardiac inflammation evaluated by ¹⁸F-FDG imaging and major adverse cardiac events (MACE) are limited. Therefore, we sought to explore the prognostic value of cardiac ¹⁸F-FDG imaging in patients with acute ST-segment elevation MI (STEMI).

Methods: Thirty-six patients with STEMI underwent ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) 5 days after primary percutaneous coronary intervention. ¹⁸F-FDG activity in infarcted and remote regions, as well as peri-coronary adipose tissue (PCAT), were measured and expressed as the maximum standardized uptake value (SUV_max). Patients were followed to determine the occurrence of MACE.

Results: The infarcted myocardium had a higher ¹⁸F-FDG intensity than the remote area. Moreover, the PCAT of culprit coronary arteries showed a higher ¹⁸F-FDG uptake than that of non-culprit arteries. Multivariate Cox regression analysis showed that increased SUV_max of PCAT [HR 5.198; 95% CI (1.058, 25.537), P = .042] was independently associated with a higher risk of MACE.

Conclusions: Enhanced PCAT activity after acute MI is related to the occurrence of MACE, and ¹⁸F-FDG PET/CT plays a promising role in providing prognostic information in patients with STEMI.