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Prognosis of Calcified Lesions Treated With PCI in Patients With Chronic Coronary Artery Disease
Julie Juul Siig1, Marc Meller Søndergaard1, Laust Dupont Rasmussen1,2
1Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Insights
Patients undergoing percutaneous coronary intervention (PCI) for chronic coronary artery disease with calcified lesions face a higher 5-year risk of myocardial infarction (MI) and death. This highlights the increased risks associated with treating calcified coronary lesions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Calcified coronary lesions are common in patients with comorbidities.
- These lesions increase the risk of complications during percutaneous coronary intervention (PCI).
Purpose of the Study:
- To evaluate the 5-year risk of myocardial infarction (MI) and all-cause mortality.
- To compare these risks in patients with and without calcified lesions undergoing PCI for chronic coronary artery disease.
Main Methods:
- Data from 16,757 patients with chronic coronary artery disease undergoing PCI (2000-2021) were analyzed.
- Patients were categorized based on the presence (32.6%) or absence (68.4%) of calcified lesions.
- The primary endpoints were MI and all-cause mortality within 5 years.
Main Results:
- Patients with calcified lesions had a significantly higher 5-year risk of MI (15.6%) compared to those without (12.8%).
- The 5-year risk of all-cause mortality was also significantly higher in patients with calcified lesions (13.6%) versus those without (8.6%).
Conclusions:
- Percutaneous coronary intervention (PCI) in the presence of calcified lesions is linked to increased risks.
- Higher 5-year risks of MI and all-cause mortality are associated with calcified coronary lesions.
Background:
Calcified coronary lesions are frequently seen in patients with comorbidities and pose a higher risk of complications during percutaneous coronary intervention (PCI).
Aims:
To evaluate the 5-year risk of acute myocardial infarction (MI) and all-cause mortality in patients with and without calcified lesions in patients with chronic coronary artery disease.
Methods:
Demographic, clinical, and procedural data were extracted from the Western Denmark Heart Registry (WDHR) for individuals with chronic coronary artery disease undergoing PCI from January 2000 to January 2021. Major exclusion criteria were prior MI and PCI. Patients were categorized according to presence of calcified lesions defined as visible calcium on angiography during the index procedure. The endpoint was MI and all-cause mortality.
Results:
In total, 16,757 patients underwent PCI due to chronic coronary artery disease of whom 5302 (32.6%) patients had calcified lesions and 11,455 (68.4%) patients had lesions without calcium. Patients with calcified lesions had significantly higher absolute 5-year risk of MI (15.6% (n = 826)) compared to patients without calcified lesions (12.8% (n = 1469)) (p < 0.0005). Patients with calcified lesions had significantly higher absolute 5-year risk for all-cause mortality (13.6% (n = 720)) compared to patients without calcified lesions (8.6% (n = 984)) (p < 0.0005).
Conclusion:
PCI of calcified lesions was associated with higher 5-year risk of MI and all-cause mortality.
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