Non-invasive in vivo coronary artery thrombus imaging

Evangelos Tzolos, Rong Bing, Jack Andrews, Mark G MacAskill, Adriana A S Tavares, Gillian Macnaught, Tim Clark, Nicholas L Mills, Takeshi Fujisawa, Jennifer Nash, Damini Dey, Piotr J Slomka, Norman Koglin, Andrew W. Stephens, Marcus-André Deutsch, Edwin J R van Beek, Michelle C Williams, Sven Hermann, Verena Hugenberg, Marc R DweckDavid E Newby

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

The diagnosis and management of myocardial infarction is increasingly complex and
establishing the presence of intracoronary thrombosis has major implications for both the
classification and treatment of myocardial infarction.
To investigate whether positron emission tomography (PET) and computed tomography (CT)
could non-invasively detect in vivo thrombus formation in human coronary arteries using a
novel glycoprotein IIb/IIIa receptor antagonist-based radiotracer, 18F-GP1.
In a single centre observational case-control study, patients with or without acute myocardial
infarction underwent coronary 18F-GP1 PET-CT angiography. Coronary artery 18F-GP1 uptake
was assessed visually and quantified using maximum target-to-background ratios.
18F-GP1 PET-CT angiography was performed in 49 patients with, and 50 patients without,
acute myocardial infarction (61±9 years, 75% male). Coronary 18F-GP1 uptake was apparent
in 39 (80%) of the 49 culprit lesions in patients with acute myocardial infarction. False negative
scans appeared to relate to time delays to scan conduct and low thrombus burden in small
calibre distal arteries. On multivariable regression analysis, culprit vessel status was the only
independent variable associated with higher 18F-GP1 uptake. Extra-coronary cardiac 18F-GP1
findings included a high frequency of infarct-related intramyocardial uptake (35%) as well as
left ventricular (8%) or left atrial (2%) thrombus.
Coronary 18F-GP1 PET-CT angiography is the first non-invasive selective technique to identify
in vivo coronary thrombosis in patients with acute myocardial infarction. This novel approach
can further define the role and location of thrombosis within the heart and has the potential to
inform the diagnosis, management, and treatment of patients with acute myocardial infarction.
Original languageEnglish
JournalJACC: Cardiovascular Imaging
Early online date14 Dec 2022
Publication statusE-pub ahead of print - 14 Dec 2022

Keywords / Materials (for Non-textual outputs)

  • Myocardial infarction
  • Intracoronary thrombosis
  • positron emission tomography
  • computed tomography


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