The PRE18FFIR trial: Coronary Plaque Activity to Predict Recurrent Events

Presented at the ESC congress 2022 by: Prof. David Newby, PhD- Edinburgh, UK

Introduction and methods

PRE18FFIR was a prospective multicenter study to examine whether non-invasive assessment of coronary atherosclerotic plaque activity predicts outcomes. Coronary atherosclerotic plaque activity was evaluated using a radioactive sodium fluoride probe to light up the inflamed disease in coronary arteries on a PET-scan. Computed tomography coronary angiography (CTCA) was performed as well. A total of 704 patients with recent MI and multivessel CAD were included in the study. The primary composite endpoint was CV death, non-fatal MI, or unscheduled coronary revascularization. Median follow-up was 4 years.

Main results

- Increased coronary atherosclerotic plaque activity was not associated with the primary endpoint (HR 1.25, 95% CI 0.89–1.76, P = 0.20), which was mainly caused by a lack of an association with unscheduled coronary revascularization (HR 0.98, 95% CI 0.64–1.49, P = 0.91).

- Secondary analyses showed that increased coronary atherosclerotic plaque activity was associated with CV death or non-fatal MI (HR 1.82; 95% CI 1.07–3.10; P = 0.03), and with all-cause mortality (HR 2.43; 95% CI 1.15–5.12; p=0.02).

Conclusion

This study showed that increased coronary atherosclerotic plaque activity, as assessed by 18F-sodium fluoride PET did not predict the primary endpoint of all coronary events but did predict all-cause mortality and CV death or non-fatal MI.

-Our reporting is based on the information provided at the ESC Congress-