Trial reportLancet (London, England)2014
18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial.
Trial report in Lancet (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 471 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Rosuvastatin Effect on Atherosclerotic Plaque Metabolism - a Subclinical Atherosclerosis Imaging Study With 18F-NaF PET-CT
Open the trial in the graphDual Antiplatelet Therapy to Inhibit Coronary Atherosclerosis and Myocardial Injury in Patients With Necrotic High-Risk Coronary Plaque Disease
Prediction of Recurrent Events With 18F-Fluoride to Identify Ruptured and High-risk Coronary Artery Plaques in Patients With Myocardial Infarction
Characterizing Vulnerable Plaques in Non-ST-Elevation Myocardial Infarction Using 18F-NaF Positron Emission Tomography - Cardiac Magnetic Resonance Imaging: A Feasibility Study
Validation of PET-MRI for Cardiovascular Disease
Combined Positron Emission Tomography and Magnetic Resonance Imaging of Coronary Atherothrombosis
In-vivo Thrombus Imaging With 18F-GP1, a Novel Platelet PET Radiotracer
Who cites it
471 citing papers in PubMed, 3 syntheses or guidelines pooled it, 937 citations in OpenAlex.
- Cracking the Code of Calcification: How Presence and Burden among Intracranial Arteries Influence Stroke Incidence and Recurrence.AJNR. American journal of neuroradiology · 2025Pooled it
- Pooled it
- Sodium fluoride in cardiovascular disorders: A systematic review.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Pooled it
- Effects of Evolocumab on Coronary Plaque Composition and Microcalcification Activity by Coronary PET and CT Angiography.JACC. Cardiovascular imaging · 2025Trial
- Head-to-head comparison ofJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2024Trial
- Effect of Denosumab or Alendronate on Vascular Calcification: Secondary Analysis of SALTIRE2 Randomized Controlled Trial.Journal of the American Heart Association · 2024Trial
- Vascular biomechanics and molecular disease activity in the thoracic aorta: a novel imaging method.European heart journal. Cardiovascular Imaging · 2022Trial
- Article
- Cardiovascular imaging with total-body PET.The British journal of radiology · 2026Review
- Coronary artery disease imaging with total-body PET.The British journal of radiology · 2026Review
- [EJNMMI research · 2026Review
- Targeting Inflammation Across the Myocardial Infarction Continuum: Biomarkers, Imaging, and Emerging Therapies.Journal of clinical medicine · 2026Review
- Mitochondrial Redox Failure Links Senescence-like Foam Cell Stress to Ferroptosis and Plaque Non-Resolution in Atherosclerosis.Antioxidants (Basel, Switzerland) · 2026Review
- The Statin Floor Effect: a Mechanistic Framework for Residual Cardiovascular Risk.Cardiovascular drugs and therapy · 2026Review
- Next-Generation Cardiovascular Imaging in Precision Medicine: Integrating Functional Imaging, Artificial Intelligence, Biomarkers, and Personalized Risk Stratification.Diagnostics (Basel, Switzerland) · 2026Review
- Impact of residential air pollution on in vitro fertilization (IVF) outcomes in New Jersey.Journal of assisted reproduction and genetics · 2026Article
- Mechanisms, precision therapies, and technological frontiers in coronary atherosclerosis: a comprehensive review.Acta pharmacologica Sinica · 2026Review
- Coronary Plaque Vulnerability and Pericoronary Adipose Tissue Inflammation: Emerging Insights from Advanced CT Imaging.Medicina (Kaunas, Lithuania) · 2026Review
- Integration of Conventional and Radiomic Features From Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Imaging for Multimodal Prediction of Symptomatic Carotid Atherosclerotic Plaques.Journal of the American Heart Association · 2026Article
- Biomechanics of Plaque Rupture and Cardiovascular Calcification.Advances in experimental medicine and biology · 2026Review
411 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
20 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe use of non-invasive imaging to identify ruptured or high-risk coronary atherosclerotic plaques would represent a major clinical advance for prevention and treatment of coronary artery disease. We used combined PET and CT to identify ruptured and high-risk atherosclerotic plaques using the radioactive tracers (18)F-sodium fluoride ((18)F-NaF) and (18)F-fluorodeoxyglucose ((18)F-FDG).
methodsIn this prospective clinical trial, patients with myocardial infarction (n=40) and stable angina (n=40) underwent (18)F-NaF and (18)F-FDG PET-CT, and invasive coronary angiography. (18)F-NaF uptake was compared with histology in carotid endarterectomy specimens from patients with symptomatic carotid disease, and with intravascular ultrasound in patients with stable angina. The primary endpoint was the comparison of (18)F-fluoride tissue-to-background ratios of culprit and non-culprit coronary plaques of patients with acute myocardial infarction.
findingsIn 37 (93%) patients with myocardial infarction, the highest coronary (18)F-NaF uptake was seen in the culprit plaque (median maximum tissue-to-background ratio: culprit 1·66 [IQR 1·40-2·25] vs highest non-culprit 1·24 [1·06-1·38], p<0·0001). By contrast, coronary (18)F-FDG uptake was commonly obscured by myocardial uptake and where discernible, there were no differences between culprit and non-culprit plaques (1·71 [1·40-2·13] vs 1·58 [1·28-2·01], p=0·34). Marked (18)F-NaF uptake occurred at the site of all carotid plaque ruptures and was associated with histological evidence of active calcification, macrophage infiltration, apoptosis, and necrosis. 18 (45%) patients with stable angina had plaques with focal (18)F-NaF uptake (maximum tissue-to-background ratio 1·90 [IQR 1·61-2·17]) that were associated with more high-risk features on intravascular ultrasound than those without uptake: positive remodelling (remodelling index 1·12 [1·09-1·19] vs 1·01 [0·94-1·06]; p=0·0004), microcalcification (73% vs 21%, p=0·002), and necrotic core (25% [21-29] vs 18% [14-22], p=0·001).
interpretation(18)F-NaF PET-CT is the first non-invasive imaging method to identify and localise ruptured and high-risk coronary plaque. Future studies are needed to establish whether this method can improve the management and treatment of patients with coronary artery disease.
fundingChief Scientist Office Scotland and British Heart Foundation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.