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Aortic Arch Calcification in Predicting Unfavorable Angiographic Outcomes for Patients with ST-Elevation Myocardial

Uğur Köktürk1, Orhan Önalan2, Mustafa Umut Somuncu3

  • 1Department of Cardiology, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.

Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre
|June 27, 2024
PubMed

Insights

Aortic arch calcification (AAC) predicts poor outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Higher AAC grades correlate with increased no-reflow, large thrombus burden (LTB), and reduced myocardial blush grade (MBG).

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Radiology

Background:

  • No-reflow, large thrombus burden (LTB), and myocardial blush grade (MBG) are linked to adverse outcomes in ST-elevation myocardial infarction (STEMI) patients post-percutaneous coronary intervention (PCI).
  • Aortic arch calcification (AAC) is a marker of subclinical atherosclerosis and is associated with cardiovascular events.

Purpose of the Study:

  • To investigate the association between aortic arch calcification (AAC) and unfavorable angiographic outcomes in STEMI patients undergoing primary PCI.
  • To determine if AAC can predict no-reflow, LTB, and MBG in this patient population.

Main Methods:

  • A prospective study included 269 consecutive STEMI patients undergoing primary PCI.
  • Patients were categorized into three groups based on AAC severity: grade 0, grade 1, and grade 2/3.
  • The relationship between AAC grade and angiographic outcomes (LTB, no-reflow, MBG) was analyzed.

Main Results:

  • Patients with grade 2/3 AAC exhibited significantly higher rates of LTB, no-reflow, and MBG 0/1 compared to those with grade 0 or 1 AAC (p < 0.05).
  • Grade 2/3 AAC was identified as an independent predictor for LTB, MBG 0/1, and no-reflow (p = 0.002, p = 0.005, p = 0.004, respectively).
  • Higher AAC grades were significantly associated with LTB, MBG 0/1, and no-reflow status.

Conclusions:

  • Aortic arch calcification serves as a reliable indicator for predicting no-reflow, MBG 0/1, and LTB in STEMI patients undergoing primary PCI.
  • AAC assessment may aid in risk stratification and management of STEMI patients.
Abstract

Keywords:
Aortic arch calcificationMyocardial blush gradeThrombus burden

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