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Methods: Patients with established coronary artery disease underwent baseline 18F-NaF PET, coronary artery calcium scoring, coronary CT angiography, and one-year repeat coronary artery calcium scoring. We quantified the whole-vessel 18F-NaF PET coronary microcalcification activity (CMA) and change in calcium scores in those with and without CABG surgery.
Results: Among 293 participants (65±9 years; 84% male), 48 (16%) had CABG surgery 2.7 [1.4-10.4] years previously. Although all arterial and the majority (120/128, 94%) of vein grafts showed no 18F-NaF uptake, 8 saphenous vein grafts in 7 subjects had detectable CMA.
Bypassed native coronary arteries had 3-times higher CMA values (2.1 (0.4-7.5) versus 0.6 (0-2.7), p<0.001) and greater progression of one-year calcium scores (118 [48-194] versus 69 [21-142] AU, p=0.01) compared to those who that had not undergone CABG: an effect largely confined to native coronary plaques proximal to the graft anastomosis. In sensitivity analysis, bypassed native coronary arteries had higher CMA (2.0 [0.4-7.5] vs 0.8 [0.3-3.2], p<0.001) and faster disease progression (24 [16-43] versus 8 [0-24] %, p=0.002) than matched patients (n=48) with comparable burdens of coronary artery disease and cardiovascular comorbidities in the absence of bypass grafting.
Conclusions: Native coronary arteries that have been bypassed, demonstrate increased disease activity and more rapid disease progression than non-bypassed arteries, an observation that appears independent of the baseline atherosclerotic plaque burden. Microcalcification activity is not a dominant feature of graft vasculopathy.
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Incidence, consequences and natural history of left ventricular thrombus after acute anterior myocardial infarction
1/02/20 → 31/01/22
1/04/19 → 31/07/21