Akihiro Nakajima1, Makoto Araki1, Osamu Kurihara1, Yoshiyasu Minami2, Tsunenari Soeda3, Taishi Yonetsu4, Filippo Crea5, Masamichi Takano6, Takumi Higuma7, Tsunekazu Kakuta8, Tom Adriaenssens9, Hang Lee10, Sunao Nakamura11, Ik-Kyung Jang1,12. 1. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. 2. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. 3. Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan. 4. Department of Interventional Cardiology, Tokyo Medical and Dental University, Tokyo, Japan. 5. Department of Cardiovascular and Thoracic Science, Catholic University of the Sacred Heart, Fondazione Policlinico Agostino Gemelli IRCCS, Roma, Italy. 6. Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Chiba, Japan. 7. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan. 8. Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan. 9. Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium. 10. Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. 11. Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan. 12. Division of Cardiology, Kyung Hee University Hospital, Seoul, South Korea.
Abstract
OBJECTIVES: To compare the postprocedural optical coherence tomography (OCT) findings and in-hospital outcomes among the three subtypes of calcified plaques: eruptive calcified nodules, superficial calcific sheet, and calcified protrusion. BACKGROUND: Recently, three subtypes of calcified culprit plaques were reported in patients with acute coronary syndrome (ACS). How these subtypes respond to stenting is unknown. METHODS: ACS patients with calcified plaque at the culprit lesion were selected from our database. OCT findings at baseline and after stent implantation were compared. RESULTS: In the final analysis, 87 cases were included. Preprocedural OCT showed eruptive calcified nodules in 19 (21.8%) cases, superficial calcific sheet in 63 (72.4%), and calcified protrusion in 5 (5.7%). Stent edge dissection (SED) and incomplete stent apposition (ISA) were frequently observed in the eruptive calcified nodules group compared to superficial calcific sheet or calcified protrusion (SED; 47.4% vs. 17.5% vs. 20.0%; p = .032, ISA; 94.7% vs. 58.7% vs. 0.0%; p < .001). The superficial calcific sheet group had the smallest minimal stent area (MSA) among the three groups (eruptive calcified nodules vs. superficial calcific sheet vs. calcified protrusion: 6.29 ± 2.41 vs. 4.72 ± 1.37 vs. 6.56 ± 1.13; p = .007). The superficial calcific sheet group had a higher rate of periprocedural myocardial infarction compared to the eruptive calcified nodules group (60.3% vs. 31.6%; p = .028). CONCLUSIONS: This study demonstrated eruptive calcified nodules are associated with higher incidence of SED and ISA, whereas superficial calcific sheets are associated with small MSA and higher periprocedural myocardial infarction.
OBJECTIVES: To compare the postprocedural optical coherence tomography (OCT) findings and in-hospital outcomes among the three subtypes of calcified plaques: eruptive calcified nodules, superficial calcific sheet, and calcified protrusion. BACKGROUND: Recently, three subtypes of calcified culprit plaques were reported in patients with acute coronary syndrome (ACS). How these subtypes respond to stenting is unknown. METHODS:ACSpatients with calcified plaque at the culprit lesion were selected from our database. OCT findings at baseline and after stent implantation were compared. RESULTS: In the final analysis, 87 cases were included. Preprocedural OCT showed eruptive calcified nodules in 19 (21.8%) cases, superficial calcific sheet in 63 (72.4%), and calcified protrusion in 5 (5.7%). Stent edge dissection (SED) and incomplete stent apposition (ISA) were frequently observed in the eruptive calcified nodules group compared to superficial calcific sheet or calcified protrusion (SED; 47.4% vs. 17.5% vs. 20.0%; p = .032, ISA; 94.7% vs. 58.7% vs. 0.0%; p < .001). The superficial calcific sheet group had the smallest minimal stent area (MSA) among the three groups (eruptive calcified nodules vs. superficial calcific sheet vs. calcified protrusion: 6.29 ± 2.41 vs. 4.72 ± 1.37 vs. 6.56 ± 1.13; p = .007). The superficial calcific sheet group had a higher rate of periprocedural myocardial infarction compared to the eruptive calcified nodules group (60.3% vs. 31.6%; p = .028). CONCLUSIONS: This study demonstrated eruptive calcified nodules are associated with higher incidence of SED and ISA, whereas superficial calcific sheets are associated with small MSA and higher periprocedural myocardial infarction.
Authors: Luyan Zhang; Yaling Tian; Hong Ren; Aihong Zhu; Li Dong; Xiuqin Wang; Xiaoyu Han Journal: Comput Math Methods Med Date: 2022-07-21 Impact factor: 2.809