Coronary disease & ACSCohort study
Stress-Related Neural Activity Associates With Coronary Plaque Vulnerability and Subsequent Cardiovascular Events
- Retrospective cohort study
Authors' conclusion
SNA is significantly correlated with FAI and HRP in patients with CAD. Furthermore, such neural activity was associated with MACE, which was mediated in part by leukopoietic activity in the bone marrow, coronary inflammation, and plaque vulnerability.
Study context
- Population
- Patients with coronary artery disease (CAD) without cancer who underwent 18F-FDG PET/CT and coronary computed tomographic angiography (CCTA), 2013–2020
- Participants
- 299 patients
- Exposure
- Heightened vs lower stress-related neural activity
- Outcome
- Association of SNA with coronary plaque features (FAI, HRP) and MACE
Main finding
As reported in the abstract
Hazard ratio
3.22
95% CI 1.31–7.93
P = 0.011
By group
Heightened SNA
40.7%
High-risk plaque (HRP) · major adverse cardiovascular events (MACE) 17.2%
Lower SNA
23.5%
HRP · MACE 5.1%
Heightened SNA vs Lower SNA
HR 3.22 (95% CI 1.31–7.93); P = 0.011
- SNA correlated with FAI (r)
- 0.49
- SNA correlated with bone-marrow activity (BMA) (r)
- 0.39
Observational data: associations, not effects.
Further findings
Mediation analysis
- Higher SNA associates with MACE via a serial mechanism involving BMA, FAI and HRP
Original publication
Stress-Related Neural Activity Associates With Coronary Plaque Vulnerability and Subsequent Cardiovascular Events. JACC Cardiovasc Imaging. Published 31 May 2023. doi:10.1016/j.jcmg.2023.04.004
Summarised from the published abstract; every number is checked against it