Impact of nodular calcification in patients with acute coronary syndrome (ACS) treated with primary percutaneous coronary intervention (PCI)

被引：11

作者：

Demuyakor, Abigail ^{[1
,2
]}

Hu, Sining ^{[1
,2
]}

Koniaeva, Ekaterina ^{[1
,2
]}

Liu, Minghao ^{[1
,2
]}

Weng, Ziqian ^{[1
,2
]}

Zhao, Chen ^{[1
,2
]}

Feng, Xue ^{[1
,2
]}

He, Luping ^{[1
,2
]}

Xu, Yishuo ^{[1
,2
]}

Zeng, Ming ^{[1
,2
]}

Meng, Wei ^{[1
,2
]}

Sun, Yanli ^{[1
,2
]}

Yi, Boling ^{[1
,2
]}

Gao, Zhanqun ^{[1
,2
]}

Qin, Yuhan ^{[1
,2
]}

Jia, Haibo ^{[1
,2
]}

Mintz, Gary S. ^{[3
]}

Yu, Bo ^{[1
,2
]}

机构：

[1] Harbin Med Univ, Dept Cardiol, Affiliated Hosp 2, 246 Xuefu Rd, Harbin 150086, Peoples R China

[2] Chinese Minist Educ, Key Lab Myocardial Ischem, 246 Xuefu Rd, Harbin 150086, Peoples R China

[3] Cardiovasc Res Fdn, New York, NY USA

来源：

BMC CARDIOVASCULAR DISORDERS | 2022年 / 22卷 / 01期

基金：

中国国家自然科学基金; 国家重点研发计划;

关键词：

Nodular calcification; Acute coronary syndrome; Percutaneous coronary intervention; Optical coherence tomography; OPTICAL COHERENCE TOMOGRAPHY; ELUTING STENT IMPLANTATION; INTRAVASCULAR ULTRASOUND ANALYSIS; ASSOCIATION TASK-FORCE; CALCIFIED NODULE; ROTATIONAL ATHERECTOMY; OUTCOMES; LESION; ACQUISITION; GUIDELINE;

D O I：

10.1186/s12872-022-02551-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Calcified plaque is thought to adversely impact outcomes after percutaneous coronary intervention (PCI). This study sought to evaluate the impact of nodular calcification in patients with acute coronary syndrome treated with primary percutaneous coronary intervention. Methods Using optical coherence tomography (OCT), 500 culprit plaques with calcification were analyzed from 495 acute coronary syndrome (ACS) patients on whom PCI was performed. Based on morphology, we classified calcification into two subtypes: nodular calcification and non-nodular calcification. Nodular calcification was defined as protruding mass with an irregular surface, high backscattering, and signal attenuation while non-nodular calcification was defined as an area with low backscattering heterogeneous region with a well-delineated border without protrusion into the lumen on OCT. Results Calcified culprit plaques were divided into nodular calcification group (n = 238) and non-nodular calcification group (n = 262). Patients with nodular calcification were older (p < 0.001) and had lower left ventricular ejection fraction (p = 0.006) compared to patients with non-nodular calcification. Minimum stent area (5.0 (3.9, 6.3) mm(2) vs. 5.4 (4.2, 6.7) mm(2), p = 0.011) and stent expansion (70 (62.7, 81.8) % vs. 75 (65.2, 86.6) %, p = 0.004) were significantly smaller in the nodular calcification group than in the non-nodular calcification group. Stent under-expansion was most frequent (p = 0.003) in the nodular calcification group. Conclusion This study demonstrate that the presence of nodular calcification is associated with a smaller minimum stent area and a higher incidence of stent under-expansion. Lesions with nodular calcification may be at risk of stent under-expansion.

引用

页数：11

共 32 条

[1] High-Speed Rotational Atherectomy Before Paclitaxel-Eluting Stent Implantation in Complex Calcified Coronary Lesions The Randomized ROTAXUS (Rotational Atherectomy Prior to Taxus Stent Treatment for Complex Native Coronary Artery Disease) Trial [J].