Prediction of optical coherence tomography-detected calcified nodules using coronary computed tomography angiography

Sugiura, Junichi; Watanabe, Makoto; Nobuta, Saki; Okamura, Akihiko; Kyodo, Atsushi; Nakamura, Takuya; Nogi, Kazutaka; Ishihara, Shoichiro; Hashimoto, Yukihiro; Ueda, Tomoya; Seno, Ayako; Onoue, Kenji; Soeda, Tsunenari; Saito, Yoshihiko

doi:10.1038/s41598-022-26599-9

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Noninvasive methods for the diagnosis of CNs are still not available. In a retrospective study, Sugiura et al explored the possibility of introducing coronary computed tomography angiography for CN detection 44 . Although the results were promising, more data are necessary.…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective study, Sugiura et al explored the possibility of introducing coronary computed tomography angiography for CN detection. 44 Although the results were promising, more data are necessary. Heterogeneity: Tau 2 = 0.02; chi 2 = 1.14, df = 1 (P = 0.20); I 2 = 13% Test for overall effect: Z = 0.07 (P = 0.94) cause of adverse events.…”

Section: Diagnosismentioning

confidence: 96%

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Coronary calcified nodules versus nonnodular coronary calcifications: a systematic review and meta-analysis

Oliveri,

Van Oort,

Al Amri

et al. 2024

Journal of Cardiovascular Medicine

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Background Percutaneous coronary intervention (PCI) on severely calcified coronary lesions is challenging. Coronary calcified nodule (CN) refers to an eccentric and protruding coronary calcification associated with plaque vulnerability and adverse clinical events. This study aims to conduct an extensive review of CNs, focusing on its prognostic impact in comparison with nonnodular coronary calcification (N-CN). Method A systematic literature review on PubMed, MEDLINE, and EMBASE databases was conducted for relevant articles. Observational studies or randomized controlled trials comparing CNs and N-CNs were included. Results Five studies comparing CNs and N-CNs were pertinent for inclusion. The total number of individuals across these studies was 1456. There were no significant differences in the baseline demographic, clinical, and angiographic data between the CN and N-CN groups. Intracoronary imaging was always utilized. At follow-up, CNs were associated with significantly increased, target vessel revascularization [odds ratio (OR) 2.16; 95% confidence interval (CI): 1.39–3.36, P-value < 0.01, I 2 = 0%] and stent thrombosis (OR 9.29; 95% CI: 1.67–51.79, P-value = 0.01, I 2 = 0%) compared with N-CN. A trend for greater cardiac death was also assessed in the CN group (OR 1.75; 95% CI: 0.98–3.13, P-value = 0.06, I 2 = 0%). Conclusion CN has a significantly negative impact on outcomes when compared with N-CN.

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Section: Discussionmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 96%

Coronary calcified nodules versus nonnodular coronary calcifications: a systematic review and meta-analysis

Oliveri,

Van Oort,

Al Amri

et al. 2024

Journal of Cardiovascular Medicine

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Atherosclerosis evaluation and cardiovascular risk estimation using coronary computed tomography angiography

Nurmohamed,

van Rosendael,

Danad

et al. 2024

European Heart Journal

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Clinical risk scores based on traditional risk factors of atherosclerosis correlate imprecisely to an individual’s complex pathophysiological predisposition to atherosclerosis and provide limited accuracy for predicting major adverse cardiovascular events (MACE). Over the past two decades, computed tomography scanners and techniques for coronary computed tomography angiography (CCTA) analysis have substantially improved, enabling more precise atherosclerotic plaque quantification and characterization. The accuracy of CCTA for quantifying stenosis and atherosclerosis has been validated in numerous multicentre studies and has shown consistent incremental prognostic value for MACE over the clinical risk spectrum in different populations. Serial CCTA studies have advanced our understanding of vascular biology and atherosclerotic disease progression. The direct disease visualization of CCTA has the potential to be used synergistically with indirect markers of risk to significantly improve prevention of MACE, pending large-scale randomized evaluation.

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Coronary intravascular lithotripsy in contemporary practice: challenges and opportunities in coronary intervention

Gupta,

Shrivastava,

Dugal

et al. 2024

Therapeutic Advances in Cardiovascular Disease

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Percutaneous coronary intervention (PCI) of calcified coronary arteries is associated with poor outcomes. Poorly modified calcified lesion hinders the stent delivery, disrupts drug-carrying polymer, impairs drug elution kinetics and results in under-expanded stent (UES). UES is the most common cause of acute stent thrombosis and in-stent restenosis after PCI of calcified lesions. Angiography has poor sensitivity for recognition and quantification of coronary calcium, thereby mandating the use of intravascular imaging. Intravascular imaging, like intravascular ultrasound and optical coherence tomography, has the potential to accurately identify and quantify the coronary calcium and to guide appropriate modification device before stent placement. Available options for the modification of calcified plaque include modified balloons (cutting balloon, scoring balloon and high-pressure balloon), atherectomy devices (rotational atherectomy and orbital atherectomy) and laser atherectomy. Coronary intravascular lithotripsy (IVL) is the newest addition to the tool box for calcified plaque modification. It produces the acoustic shockwaves, which interact with the coronary calcium to cause multiplanar fractures. These calcium fractures increase the vessel compliance and result in desirable minimum stent areas. Coronary IVL has established its safety and efficacy for calcified lesion in series of Disrupt CAD trials. Its advantages over atherectomy devices include ease of use on workhorse wire, ability to modify deep calcium, no debris embolization causing slow flow or no-flow and minimal thermal injury. It is showing promising results in modification of difficult calcified lesion subsets such as calcified nodule, calcified left main bifurcation lesions and chronic total occlusion. In this review, authors will summarize the mechanism of action for IVL, its role in contemporary practice, evidence available for its use, its advantages over atherectomy devices and its imaging insight in different calcified lesion scenarios.

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Prediction of optical coherence tomography-detected calcified nodules using coronary computed tomography angiography

Cited by 3 publications

References 27 publications

Coronary calcified nodules versus nonnodular coronary calcifications: a systematic review and meta-analysis

Coronary calcified nodules versus nonnodular coronary calcifications: a systematic review and meta-analysis

Atherosclerosis evaluation and cardiovascular risk estimation using coronary computed tomography angiography

Coronary intravascular lithotripsy in contemporary practice: challenges and opportunities in coronary intervention

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