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Updated: Mar 1, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Patients with acute myocardial infarction and severe target lesion calcifications undergoing percutaneous coronary
Wojciech J Zimoch1, Piotr Kubler, Michał Kosowski
1Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland, Poland; 4th Military Hospital, Wroclaw, Poland, Poland. zimoch.w@gmail.com.
Insights
Severe target lesion calcification (TLC) in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) is linked to poorer outcomes. This condition predicts recurrent acute coronary syndrome (ACS) and higher mortality.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Contemporary data on coronary artery calcification (CAC) often comes from short-term randomized trials.
- Real-world, long-term prognostic data on target lesion calcification (TLC) in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) is limited.
Purpose of the Study:
- To evaluate the impact of severe TLC on patient outcomes after PCI for AMI.
- To determine if severe TLC influences long-term prognosis in a real-world setting.
Main Methods:
- Clinical and laboratory data from 206 consecutive AMI patients undergoing coronary angiography and PCI were analyzed.
- Primary endpoints included all-cause death and rehospitalization for acute coronary syndrome (ACS).
- Follow-up duration was 30 months.
Main Results:
- Severe TLC was identified in 17% of patients, who were older and more frequently had non-ST segment elevation myocardial infarction.
- Patients with severe TLC experienced lower PCI success rates (80% vs. 97%) and less frequent complete revascularization (14% vs. 41%).
- Severe TLC was associated with significantly higher rates of recurrent ACS (37% vs. 13%) and all-cause mortality (31% vs. 16%) during follow-up. Severe TLC independently predicted another ACS (HR 2.8).
Conclusions:
- Severe TLC is a common finding in patients with ACS undergoing PCI.
- The presence of severe TLC is a significant independent prognostic factor for recurrent ACS in AMI patients treated with PCI.
Background:
To assess the influence of severe target lesion calcification (TLC) on the outcomes of patients undergoing percutaneous coronary interventions (PCI) due to acute myocardial infarction (AMI).
Aim:
Contemporary data concerning coronary artery calcifications (CAC) are based on pooled analyses from randomised trials with short follow-up. We still lack the knowledge on how CAC in target lesions affect long-term prognosis of patients with AMI in everyday practice.
Methods:
We evaluated clinical and laboratory data of 206 consecutive patients who underwent coronary angiography and PCI due to AMI. Primary endpoints were all-cause death and recurrent hospitalisations due to acute coronary syndrome (ACS).
Results:
Severe TLC lesions were present in 17% of patients. These patients were older (71 vs. 65 years, p = 0.02) and more often diagnosed with non-ST segment elevation myocardial infarction (77% vs. 58%, p = 0.03). Patients with severe TLC had lower rates of PCI success (80% vs. 97%, p < 0.0001) and less often achieved full revascularisation during index procedure (14% vs. 41%, p = 0.003). During 30 months follow-up patients with severe TLC more often suffered from another ACS (37% vs. 13%, p = 0.0005) and had higher all-cause mortality (31% vs. 16%, p = 0.04). Multivariate Cox regression model showed severe TLC to be an independent predictor of another ACS (HR 2.8; 95% CI 1.4-5.6; p = 0.004).
Conclusions:
Severe TLC are not uncommon in patients with ACS. The presence of severe TLC is a prognostic factor of another ACS in AMI patients undergoing PCI.
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