POS0096\u2005SPLENIC METABOLIC UPTAKE IN FDG-PET/CT PREDICTS RISK OF FUTURE CARDIOVASCULAR THROMBOSIS EVENTS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Patients with the rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) compared to general population. However there are insufficient modality to predict future CVD risk in RA.This study assessed whether splenic and arterial activity measured by positron emission tomography/ computed tomography (PET/CT) predict the risk of CVD thrombosis events beyond conventional risk factors in patients with RA.We enrolled 84 patients with active RA who underwent fluorine-18-fluorodeoxyglucose (FDG) PET/CT and disease activity evaluation at the same time. CVD thrombosis events were independently evaluated, while blinded to activity of PET/CT, during follow up periods. FDG uptake by nuclear medicine physician was examined in the spleen and ascending aorta and blood pool activity of superior vena cava as SUV (standardized uptake values) and target-to-background-ratio (TBR) while blinded to CVD events.During follow-up periods, 19 patients developed CVD thrombosis events. Both splenic and arterial TBR were significantly increased in patients with subsequent CVD events compared to in patients without (2.19 ± 0.60 vs 1.80 ± 0.34, p < 0.013, 1.72 ± 0.22 vs 1.57 ± 0.22, p< 0.012). Splenic TBR was associated with an increased risk of CVD events after adjustment for conventional CVD risk factors [hazard ratio (HR): 3.15; 95% confidence interval (CI): 1.46 to 6.79; p = 0.003]. Moreover, the association between splenic TBR and CVD events remained significant after adjustment for disease activity (HR: 3.00; CI: 1.36 to 6.63; p = 0.007) and after adjustment for arterial TBR (HR: 3.00; CI: 1.36 to 6.63; p = 0.007).Our results show splenic metabolic uptake in FDG-PET/CT in patients with RA provide information for subsequent CVD events beyond conventional risk factors.[1]Lee SJ, Jeong JH, Lee CH, et al. Development and validation of an (18) F-fluorodeoxyglucose-positron emission tomography with computed tomography-based tool for the evaluation of joint counts and disease activity in patients with rheumatoid arthritis. Arthritis Rheumatol. 2019;71:1232-1240.None declared