Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
Risk Profile and Prognostic Implications of Percutaneous Coronary Intervention Procedure Failure in Patients With Moderate-to-Severe Coronary Artery Calcification.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Lin Zhangyu, Zheng Zhihao, Yang Min, Liu QianQian, Li Bowen, Yuan Sheng, He Jining, Feng Lei, Dou Kefei
Аннотация
BACKGROUND: Arterial calcification is an important characteristic of vascular aging. Risk factors and clinical outcomes of percutaneous coronary intervention (PCI) procedure failure in patients with moderate-to-severe coronary artery calcification (MSCAC) have not been adequately assessed. We aimed to analyze the characteristics, risk factors, and long-term clinical outcomes for patients with MSCAC with PCI procedure failure.
METHODS: We analyzed 26253 patients undergoing PCI at Fuwai Hospital between January 2017 and December 2018. Procedure failure was defined as residual stenosis ≥ 50%, severe angiographic complications, in-hospital death, or in-hospital myocardial infarction (MI). The primary endpoint was CV events, including CV death, nonfatal MI, and nonfatal stroke.
RESULTS: During a median 3-year follow-up, 613 CV events were recorded. The incidence of PCI procedure failure for MSCAC patients was 10.96%. Compared with non-MSCAC patients, the multivariable-adjusted hazard ratio (aHR) for CV events was 2.38 (95% CI: 1.65-3.44) for MSCAC with PCI failure subjects, while no significant difference could be found between non-MSCAC patients and MSCAC with PCI success patients. MSCAC patients with PCI procedure failure showed an increased risk of CV events (aHR: 2.16; 95% CI: 1.39-3.38) than those with procedure success. Application of intravascular ultrasound and rotational atherectomy were independent protective factors for the occurrence of MSCAC-PCI procedure failure in patients with severe calcification.
CONCLUSIONS: MSCAC patients with PCI procedure failure showed unfavorable long-term clinical outcomes compared with those with PCI procedure success. IVUS and rotational atherectomy could reduce the risk of PCI procedure failure occurrence.
METHODS: We analyzed 26253 patients undergoing PCI at Fuwai Hospital between January 2017 and December 2018. Procedure failure was defined as residual stenosis ≥ 50%, severe angiographic complications, in-hospital death, or in-hospital myocardial infarction (MI). The primary endpoint was CV events, including CV death, nonfatal MI, and nonfatal stroke.
RESULTS: During a median 3-year follow-up, 613 CV events were recorded. The incidence of PCI procedure failure for MSCAC patients was 10.96%. Compared with non-MSCAC patients, the multivariable-adjusted hazard ratio (aHR) for CV events was 2.38 (95% CI: 1.65-3.44) for MSCAC with PCI failure subjects, while no significant difference could be found between non-MSCAC patients and MSCAC with PCI success patients. MSCAC patients with PCI procedure failure showed an increased risk of CV events (aHR: 2.16; 95% CI: 1.39-3.38) than those with procedure success. Application of intravascular ultrasound and rotational atherectomy were independent protective factors for the occurrence of MSCAC-PCI procedure failure in patients with severe calcification.
CONCLUSIONS: MSCAC patients with PCI procedure failure showed unfavorable long-term clinical outcomes compared with those with PCI procedure success. IVUS and rotational atherectomy could reduce the risk of PCI procedure failure occurrence.