Relation between thoracic aortic inflammation and features of plaque vulnerability in the coronary tree in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. An FDG-positron emission tomography and optical coherence tomography study

  • Nevio Taglieri
  • Cristina Nanni
  • Gabriele Ghetti
  • Rachele Bonfiglioli
  • Francesco Saia
  • Maria Letizia Bacchi Reggiani
  • Giacomo Maria Lima
  • Valeria Marco
  • Francesco Prati
  • Stefano Fanti
  • Claudio Rapezzi
Original Article



To evaluate the relationship between aortic inflammation as assessed by 18F–fluorodeoxyglucose-positron emission tomography (18F–FDG-PET) and features of plaque vulnerability as assessed by frequency domain-optical coherence tomography (FD-OCT).


We enrolled 30 consecutive non-ST-segment elevation acute coronary syndrome patients undergoing percutaneous coronary intervention. All patients underwent three-vessel OCT before intervention and 18F–FDG-PET before discharge. Univariable and C-reactive protein (CRP)-adjusted linear regression analyses were performed between features of vulnerability [namely:lipid-rich plaques with and without macrophages and thin cap fibroatheromas (TCFA)] and 18F–FDG uptake in both ascending (AA) and descending aorta (DA) [measured either as averaged mean and maximum target-to-blood ratio (TBR) or as active slices (TBRmax ≥ 1.6)].


Mean age was 62 years, and 26 patients were male. On univariable linear regression analysis TBRmean and TBRmax in DA was associated with the number of lipid-rich plaques (β = 4.22; 95%CI 0.05–8.39; p = 0.047 and β = 3.72; 95%CI 1.14–6.30; p = 0.006, respectively). TBRmax in DA was also associated with the number of lipid-rich plaques containing macrophages (β = 2.40; 95%CI 0.07–4.72; p = 0.044). A significant CRP adjusted linear association between the TBRmax in DA and the number of lipid-rich plaques was observed (CRP-adjusted β = 3.58; 95%CI -0.91-6.25; p = 0.01). TBRmax in DA showed a trend towards significant CRP-adjusted association with number of lipid-rich plaques with macrophages (CRP-adjusted β = 2.30; 95%CI -0.11-4.71; p = 0.06). We also observed a CRP-adjusted (β = 2.34; 95%CI 0.22–4.47; p = 0.031) linear association between the number of active slices in DA and the number of lipid-rich plaques. No relation was found between FDG uptake in the aorta and the number of TCFAs.


In patients with first NSTEACS, 18F–FDG uptake in DA is correlated with the number of OCT detected lipid-rich plaques with or without macrophages. This association may be independent from CRP values.


18F–fluorodeoxyglucose-positron emission tomography Frequency domain-optical coherence tomography Non ST-segment elevation acute coronary syndrome 


Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


This work was supported by Department of Experimental, Diagnostic and Speciality Medicine - DIMES, University of Bologna and by Fanti Melloni Foundation (grant number = not applicable).

Conflict of interest

F.P. is a consultant for ST. Jude Medical. The remaining authors have no conflicts of interest to declare.

Ethical approval

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

259_2017_3747_MOESM1_ESM.docx (13 kb)
Table S1 (DOCX 13 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Nevio Taglieri
    • 1
  • Cristina Nanni
    • 2
  • Gabriele Ghetti
    • 1
  • Rachele Bonfiglioli
    • 2
  • Francesco Saia
    • 1
  • Maria Letizia Bacchi Reggiani
    • 1
  • Giacomo Maria Lima
    • 2
  • Valeria Marco
    • 3
  • Francesco Prati
    • 3
    • 4
  • Stefano Fanti
    • 2
  • Claudio Rapezzi
    • 1
  1. 1.Istituto di Cardiologia, Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleAlma Mater Studiorum Università di BolognaBolognaItaly
  2. 2.Istituto di Medicina Nucleare, Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleAlma Mater Studiorum Università di BolognaBolognaItaly
  3. 3.CLI FoundationRomeItaly
  4. 4.GVM Care & ResearchEttore Sansavini Health Science FoundationCotignolaItaly

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