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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Impact of Calcified Nodules on Clinical Outcomes in Hemodialysis Patients Undergoing Percutaneous Coronary

Tatsuo Yokomine1, Takashi Kajiya2, Tatsuro Takei2

  • 1Department of Cardiology, Tenyoukai Central Hospital, Kagoshima, Japan; Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

The American Journal of Cardiology
|March 10, 2025
PubMed

Insights

Calcified nodules (CNs) significantly increase major adverse cardiovascular events (MACE) and cardiovascular death risk in hemodialysis patients undergoing percutaneous coronary intervention (PCI). These findings highlight the critical need for careful management of CNs in this high-risk population.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Nephrology

Background:

  • Calcified nodules (CNs) are linked to poor outcomes post-percutaneous coronary intervention (PCI).
  • CNs occur more frequently in hemodialysis patients, a population with increased cardiovascular risk.
  • The specific prognosis of CNs in hemodialysis patients undergoing PCI remains under-investigated.

Purpose of the Study:

  • To investigate the 1-year prognosis of hemodialysis patients with CNs who underwent PCI.
  • To compare the incidence of major adverse cardiovascular events (MACE) between patients with and without CNs.

Main Methods:

  • Retrospective analysis of 141 hemodialysis patients undergoing PCI between January 2020 and December 2021.
  • Intravascular ultrasound (IVUS) and/or optical coherence tomography (OCT)/optical frequency domain imaging (OFDI) used for diagnosis.
  • MACE (cardiovascular death, target lesion myocardial infarction, target lesion revascularization) was the primary endpoint.

Main Results:

  • Patients with CNs showed a significantly higher incidence of MACE at 1 year (39.2% vs 9.9%, p <0.001).
  • Cardiovascular death rates were also significantly higher in the CNs group (17.7% vs 4.2%, p = 0.009).
  • CNs were independently associated with an increased risk of MACE (adjusted hazard ratio: 4.93, p <0.001).

Conclusions:

  • Calcified nodules are associated with a substantially higher risk of MACE in hemodialysis patients undergoing PCI.
  • The presence of CNs independently predicts adverse cardiovascular outcomes, including increased cardiovascular mortality, in this patient cohort.

Keywords:
IVUSOCTcalcified nodulescoronary artery calcificationhemodialysis

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