Original Research

DOI: 10.4244/EIJ-D-24-00362

Natural history of a newly developed calcified nodule: incidence, predictors, and clinical outcomes

Yoichiro Sugizaki1,2,3,4, MD, PhD; Mitsuaki Matsumura1, PhD; YuWei Chen1,3, MD; Takunori Tsukui1,2,3, MD, PhD; Evan Shlofmitz2, DO; Susan V. Thomas2, MPH; Sarah Malik2, MD; Ali Dakroub2, MD; Mandeep Singh2, BS; Doosup Shin2, MD; Matthew J. Granville2, BA; Jordan M. Busch2, BS; Eric H. Wolff2, BS; Genie M. Miraglia2, BS; Jeffrey W. Moses1,2,3, MD; Omar K. Khalique1,2, MD; David J. Cohen1,2, MD, MSc; Gary S. Mintz1, MD; Richard A. Shlofmitz2, MD; Allen Jeremias1,2, MD, MSc; Ziad A. Ali1,2,5, MD, DPhil; Akiko Maehara1,3, MD

Abstract

Background: Calcified nodules (CNs) are an increasingly important, high-risk lesion subset.

Aims: We sought to identify the emergence of new CNs and the relation between underlying plaque characteristics and new CN development.

Methods: Patients who had undergone two optical coherence tomography (OCT) studies that imaged the same untreated calcified lesion at baseline and follow-up were included. New CNs were an accumulation of small calcium fragments at follow-up that were not present at baseline. Cardiac death, myocardial infarction (MI), or clinically driven revascularisation related to OCT-imaged, but untreated, calcified lesions were then evaluated.

Results: Among 372 untreated calcified lesions, with a median of 1.5 (first and third quartiles: 0.7-2.9) years between baseline and follow-up OCTs, new CNs were observed in 7.0% (26/372) of lesions at follow-up. Attenuated calcium representing residual lipid (odds ratio [OR] 3.38, 95% confidence interval [CI]: 1.15-9.98; p=0.03); log10 calcium volume index (length×maximum arc×maximum thickness; OR 2.76, 95% CI: 1.10-6.95; p=0.03); angiographic Δangle between systole and diastole, per 10° (OR 2.30, 95% CI: 1.25-4.22; p=0.01); and time since baseline OCT, per year (OR 1.36, 95% CI: 1.05-1.75; p=0.02) were all associated with new CN development. Clinical events were revascularisation and/or MI and were more frequent in lesions with versus without a new CN (29.3% vs 15.3%; p=0.04).

Conclusions: New CNs developed in untreated, lipid-containing, severely calcified lesions with a larger angiographic hinge motion (between systole and diastole), compared with lesions without CNs, and were associated with worse clinical outcomes.

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 20 Number 21
Nov 4, 2024
Volume 20 Number 21
View full issue


Key metrics

Suggested by Cory

10.4244/EIJV16I5A65 Aug 28, 2020
OCT-derived coronary calcified nodules as a predictor of high-risk patients
Akasaka T and Kubo T
free

Clinical Research

10.4244/EIJ-D-21-00504 Mar 18, 2022
Prevalence, predictors, and outcomes of in-stent restenosis with calcified nodules
Tada T et al
free

Debate

10.4244/EIJ-E-23-00002 Jun 5, 2023
All calcified nodules are made equal and require the same approach: pros and cons
Guagliumi G et al
free

CLINICAL RESEARCH

10.4244/EIJ-D-17-00962 Apr 6, 2018
A new optical coherence tomography-based calcium scoring system to predict stent underexpansion
Fujino A et al
free

CLINICAL RESEARCH

10.4244/EIJ-D-16-00139 Jun 20, 2017
Three-dimensional volumetric assessment of coronary artery calcification in patients with stable coronary artery disease by OCT
Krishnamoorthy P et al
free
Trending articles
152.9

Clinical research

10.4244/EIJ-D-20-01125 Oct 20, 2021
An upfront combined strategy for endovascular haemostasis in transfemoral transcatheter aortic valve implantation
Costa G et al
free
47.8

NEW INNOVATION

10.4244/EIJ-D-15-00467 Feb 20, 2018
Design and principle of operation of the HeartMate PHP (percutaneous heart pump)
Van Mieghem NM et al
free
39.1

Clinical research

10.4244/EIJ-D-22-00558 Feb 6, 2023
Permanent pacemaker implantation and left bundle branch block with self-expanding valves – a SCOPE 2 subanalysis
Pellegrini C et al
free
38.95

State-of-the-Art

10.4244/EIJ-D-23-00912 Oct 7, 2024
Optical coherence tomography to guide percutaneous coronary intervention
Almajid F et al
free
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2024 Europa Group - All rights reserved