{"title":"在器械导向复合终点(DoCE)上，接受旋转动脉粥样硬化切除术辅助经皮冠状动脉介入治疗的严重钙化病变患者的血管内超声检测钙化结节和/或结节钙化的特征和模式。","authors":"Ploy Pengchata, Rungtiwa Pongakasira, Namthip Wongsawangkit, Asa Phichaphop, Nattawut Wongpraparut","doi":"10.1155/2023/6456695","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine characteristics and pattern of a calcified nodule (CN) and/or nodular calcification (NC) detected by intravascular ultrasound (IVUS) on the device-oriented composite endpoint (DoCE) in patients with calcified lesions who underwent rotational atherectomy (RA)-assisted percutaneous coronary intervention (PCI).</p><p><strong>Background: </strong>The characteristics and pattern of a CN and/or NC on clinical outcome remain unknown.</p><p><strong>Methods: </strong>We retrospectively enrolled patients who underwent RA-assisted PCI at Siriraj Hospital during August 2016 to April 2020. Preprocedural IVUS imaging was mandatory. CN/NC was defined as convex shape of luminal surface and luminal side of calcium with protrusion into the coronary artery lumen as assessed by IVUS. The primary outcome was cumulative of DoCE, defined as the composite of cardiovascular death, myocardial infarction, and clinically-driven target lesion revascularization.</p><p><strong>Results: </strong>Two hundred patients were included. Primary outcome occurred in 14%. The cumulative DoCE was significantly higher in the CN/NC group than that in the non-CN/NC group (20.7% vs. 8.8%, <i>p</i> = 0.022). CN/NC (<i>p</i> = 0.023) and MSA ≤ 5.5 mm<sup>2</sup> (<i>p</i> = 0.047) were correlated with a significantly higher cumulative DoCE. CN/NC was the independent predictor for the cumulative DoCE (HR = 2.96, 95% CI 1.08-8.11, <i>p</i> = 0.035). Pattern and characteristic of CN/NC have a prognostic value. Patients with an eccentric CN/NC had a significantly higher cumulative DoCE compared to those CN/NC with concentric calcification (<i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>The presence of a CN/NC in patients with heavily calcified lesions who underwent RA-assisted PCI was found to be associated with increased cumulative 5 year DoCE, especially in patients with an eccentric CN/NC. The clinical trial is registered with TCTR20210616001.</p>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 ","pages":"6456695"},"PeriodicalIF":1.6000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884160/pdf/","citationCount":"4","resultStr":"{\"title\":\"Characteristics and Pattern of Calcified Nodule and/or Nodular Calcification Detected by Intravascular Ultrasound on the Device-Oriented Composite Endpoint (DoCE) in Patients with Heavily Calcified Lesions Who Underwent Rotational Atherectomy-Assisted Percutaneous Coronary Intervention.\",\"authors\":\"Ploy Pengchata, Rungtiwa Pongakasira, Namthip Wongsawangkit, Asa Phichaphop, Nattawut Wongpraparut\",\"doi\":\"10.1155/2023/6456695\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to determine characteristics and pattern of a calcified nodule (CN) and/or nodular calcification (NC) detected by intravascular ultrasound (IVUS) on the device-oriented composite endpoint (DoCE) in patients with calcified lesions who underwent rotational atherectomy (RA)-assisted percutaneous coronary intervention (PCI).</p><p><strong>Background: </strong>The characteristics and pattern of a CN and/or NC on clinical outcome remain unknown.</p><p><strong>Methods: </strong>We retrospectively enrolled patients who underwent RA-assisted PCI at Siriraj Hospital during August 2016 to April 2020. Preprocedural IVUS imaging was mandatory. CN/NC was defined as convex shape of luminal surface and luminal side of calcium with protrusion into the coronary artery lumen as assessed by IVUS. The primary outcome was cumulative of DoCE, defined as the composite of cardiovascular death, myocardial infarction, and clinically-driven target lesion revascularization.</p><p><strong>Results: </strong>Two hundred patients were included. Primary outcome occurred in 14%. The cumulative DoCE was significantly higher in the CN/NC group than that in the non-CN/NC group (20.7% vs. 8.8%, <i>p</i> = 0.022). CN/NC (<i>p</i> = 0.023) and MSA ≤ 5.5 mm<sup>2</sup> (<i>p</i> = 0.047) were correlated with a significantly higher cumulative DoCE. CN/NC was the independent predictor for the cumulative DoCE (HR = 2.96, 95% CI 1.08-8.11, <i>p</i> = 0.035). Pattern and characteristic of CN/NC have a prognostic value. Patients with an eccentric CN/NC had a significantly higher cumulative DoCE compared to those CN/NC with concentric calcification (<i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>The presence of a CN/NC in patients with heavily calcified lesions who underwent RA-assisted PCI was found to be associated with increased cumulative 5 year DoCE, especially in patients with an eccentric CN/NC. The clinical trial is registered with TCTR20210616001.</p>\",\"PeriodicalId\":16329,\"journal\":{\"name\":\"Journal of interventional cardiology\",\"volume\":\"2023 \",\"pages\":\"6456695\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884160/pdf/\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of interventional cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/6456695\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of interventional cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/6456695","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 4
摘要
目的:本研究旨在确定在器械导向的复合终点(DoCE)上，接受旋转动脉粥样硬化切除术(RA)辅助经皮冠状动脉介入治疗(PCI)的钙化病变患者的血管内超声(IVUS)检测到的钙化结节(CN)和/或结节性钙化(NC)的特征和模式。背景:CN和/或NC的特点和模式对临床结果的影响尚不清楚。方法:回顾性纳入2016年8月至2020年4月在Siriraj医院接受ra辅助PCI治疗的患者。术前IVUS成像是强制性的。静脉造影(IVUS)将CN/NC定义为腔面和腔面钙质呈凸状，并向冠状动脉腔内突出。主要终点是累积的DoCE，定义为心血管死亡、心肌梗死和临床驱动的靶病变血运重建的组合。结果:纳入200例患者。主要结局发生在14%。CN/NC组的累积DoCE明显高于非CN/NC组(20.7%比8.8%，p = 0.022)。CN/NC (p = 0.023)和MSA≤5.5 mm2 (p = 0.047)与累积DoCE显著升高相关。CN/NC是累积DoCE的独立预测因子(HR = 2.96, 95% CI 1.08-8.11, p = 0.035)。CN/NC的模式和特征具有预测价值。偏心型CN/NC患者的累积DoCE明显高于同轴型CN/NC患者(p = 0.014)。结论:严重钙化病变的患者在接受ra辅助PCI治疗时，发现CN/NC的存在与累积5年DoCE增加有关，特别是在CN/NC偏心的患者中。临床试验注册号为TCTR20210616001。
Characteristics and Pattern of Calcified Nodule and/or Nodular Calcification Detected by Intravascular Ultrasound on the Device-Oriented Composite Endpoint (DoCE) in Patients with Heavily Calcified Lesions Who Underwent Rotational Atherectomy-Assisted Percutaneous Coronary Intervention.
Objectives: This study aimed to determine characteristics and pattern of a calcified nodule (CN) and/or nodular calcification (NC) detected by intravascular ultrasound (IVUS) on the device-oriented composite endpoint (DoCE) in patients with calcified lesions who underwent rotational atherectomy (RA)-assisted percutaneous coronary intervention (PCI).
Background: The characteristics and pattern of a CN and/or NC on clinical outcome remain unknown.
Methods: We retrospectively enrolled patients who underwent RA-assisted PCI at Siriraj Hospital during August 2016 to April 2020. Preprocedural IVUS imaging was mandatory. CN/NC was defined as convex shape of luminal surface and luminal side of calcium with protrusion into the coronary artery lumen as assessed by IVUS. The primary outcome was cumulative of DoCE, defined as the composite of cardiovascular death, myocardial infarction, and clinically-driven target lesion revascularization.
Results: Two hundred patients were included. Primary outcome occurred in 14%. The cumulative DoCE was significantly higher in the CN/NC group than that in the non-CN/NC group (20.7% vs. 8.8%, p = 0.022). CN/NC (p = 0.023) and MSA ≤ 5.5 mm2 (p = 0.047) were correlated with a significantly higher cumulative DoCE. CN/NC was the independent predictor for the cumulative DoCE (HR = 2.96, 95% CI 1.08-8.11, p = 0.035). Pattern and characteristic of CN/NC have a prognostic value. Patients with an eccentric CN/NC had a significantly higher cumulative DoCE compared to those CN/NC with concentric calcification (p = 0.014).
Conclusion: The presence of a CN/NC in patients with heavily calcified lesions who underwent RA-assisted PCI was found to be associated with increased cumulative 5 year DoCE, especially in patients with an eccentric CN/NC. The clinical trial is registered with TCTR20210616001.
期刊介绍：
Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including:
Acute coronary syndrome
Coronary disease
Congenital heart diseases
Myocardial infarction
Peripheral arterial disease
Valvular heart disease
Cardiac hemodynamics and physiology
Haemostasis and thrombosis
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