Abstract
PurposeAn acute coronary syndrome (ACS) is characterized by a multi-level inflammatory response, comprising activation of bone marrow and spleen accompanied by augmented release of leukocytes into the circulation. The duration of this response after an ACS remains unclear. Here, we assessed the effect of an ACS on the multi-level inflammatory response in patients both acutely and after 3 months.MethodsWe performed 18F-DPA-714 PET/CT acutely and 3 months post-ACS in eight patients and eight matched healthy controls. DPA-714, a PET tracer binding the TSPO receptor and highly expressed in myeloid cells, was used to assess hematopoietic activity. We also characterized circulating monocytes and hematopoietic stem and progenitor cells (HSPCs) by flow cytometry in 20 patients acutely and 3 months post-ACS and in 19 healthy controls.ResultsIn the acute phase, patients displayed a 1.4-fold and 1.3-fold higher 18F-DPA-714 uptake in, respectively, bone marrow (p = 0.012) and spleen (p = 0.039) compared with healthy controls. This coincided with a 2.4-fold higher number of circulating HSPCs (p = 0.001). Three months post-ACS, 18F-DPA-714 uptake in bone marrow decreased significantly (p = 0.002), but no decrease was observed for 18F-DPA-714 uptake in the spleen (p = 0.67) nor for the number of circulating HSPCs (p = 0.75).Conclusions18F-DPA-714 PET/CT reveals an ACS- triggered hematopoietic organ activation as initiator of a prolonged cellular inflammatory response beyond 3 months, characterized by a higher number of circulating leukocytes and their precursors. This multi-level inflammatory response may provide an attractive target for novel treatment options aimed at reducing the high recurrence rate post-ACS.
Highlights
In the first 6–9 months following an acute coronary syndrome (ACS), patients face a disproportionally increased risk of reinfarction [1]
Blood withdrawal for flow cytometry and the measurement of lipid levels and inflammatory parameters was performed within 3 days and 3 months post-ACS. 18F-DPA-714 positron emission tomography/ computed tomography (PET/CT) was performed within 10–18 days and 3 months post-ACS
Patients with an ACS had an adverse cardiovascular risk profile compared with healthy controls, including a higher body mass index (BMI), a higher prevalence of hypertension and a trend towards more active smokers
Summary
In the first 6–9 months following an acute coronary syndrome (ACS), patients face a disproportionally increased risk of reinfarction [1]. Following an ACS in patients, studies have substantiated that 18F-fluordeoxyglucose (18F-FDG) uptake in bone-marrow and spleen is increased, visualized with positron emission tomography/ computed tomography (PET/CT). This increased uptake coincides with increased inflammatory parameters in plasma and arterial wall inflammation [4, 5]. Whether this multi-level inflammatory response persists after the acute phase, thereby potentially contributing to the increased reinfarction risk post-ACS, remains unclear
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: European Journal of Nuclear Medicine and Molecular Imaging
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
