Cardiovascular Sciences Department, San Giovanni Addalorata Hospital, Rome, Italy.
EuroIntervention. 2020 Aug 28;16(5):380-386. doi: 10.4244/EIJ-D-19-01120.
The goal of the present post hoc analysis of the CLIMA registry was to establish the relationship between calcified nodules (CNs) with (CND) or without (CNWD) disruption of the superficial intimal fibrous layer and one-year occurrence of target lesion myocardial infarction (MI) and/or cardiac death.
CND and CNWD were identified based on the presence or absence of superficial irregularities indicative of disruption of the intimal fibrous layer, with possible overlying local thrombus. In total, 222 CNs were found in the 1,776 non-culprit LAD plaques. CND had larger maximum calcific arc and smaller lumen area. Cardiac death and MI occurred in 20% of patients in the CND group versus 2.7% in the CNWD group and 3.3% in the group without CN (p<0.001). This figure was mainly due to the 13.3% incidence of cardiac death in the CND group versus 2.0% in the CNWD group and versus 2.2% in the group without CN (p<0.001). The presence of CND was confirmed as an independent predictor of events (HR 6.58, 95% CI: 2.7-15.8, p<0.001).
The presence of CND was associated with a high one-year incidence of cardiac death and/or target lesion MI.
本 CLIMA 注册研究的事后分析旨在确定伴有（CND）或不伴有（CNWD）浅层内膜纤维层中断的钙化结节（CN）与一年内心肌梗死（MI）和/或心脏死亡的发生之间的关系。
根据是否存在提示内膜纤维层中断的浅层不规则性（可能伴有局部覆盖的血栓）来识别 CND 和 CNWD。在 1776 个非罪犯性左前降支斑块中发现了 222 个 CN。CND 具有更大的最大钙化弧和更小的管腔面积。在 CND 组中，有 20%的患者发生心脏死亡和 MI，而在 CNWD 组中为 2.7%，在无 CN 组中为 3.3%（p<0.001）。这主要是由于 CND 组中 13.3%的心脏死亡发生率高于 CNWD 组的 2.0%和无 CN 组的 2.2%（p<0.001）。CND 的存在被确认为事件的独立预测因子（HR 6.58，95%CI：2.7-15.8，p<0.001）。
CND 的存在与一年内心脏死亡和/或靶病变 MI 的高发生率相关。
