Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
EuroIntervention. 2022 Mar 18;17(16):1352-1361. doi: 10.4244/EIJ-D-21-00504.
Calcified nodules (CN) have been reported as being associated with stent failure including in-stent restenosis (ISR). However, there is no systematic study of this condition.
We aimed to clarify the prevalence, predictors, and midterm results of ISR lesions with CN.
We examined the clinical characteristics of 651 ISR lesions in patients who underwent percutaneous coronary intervention (PCI) with optical coherence tomography (OCT) between October 2008 and July 2016, and their 6- to 8-month follow-up angiography results. CN was defined as a high backscattering mass with small nodular calcium depositions which protruded into the vessel lumen.
Thirty-two ISR lesions (4.9%) had CN. Multivariable analysis showed that calcified lesion (odds ratio [OR] 12.441, p<0.001), incomplete stent apposition (OR 3.228, p=0.005), haemodialysis (OR 3.633, p=0.024), and female gender (OR 3.212, p=0.036) were independently associated with ISR lesions with CN. Midterm follow-up was performed on 612 ISR lesions. Both ISR and target lesion revascularisation (TLR) rates were significantly higher in lesions with CN compared with those without CN (43.8% vs 25.0%, p=0.023; 37.5% vs 18.8%, p=0.020, respectively). However, multivariate analysis did not show the presence of CN as an independent predictor of re-TLR (OR 1.690, p=0.286).
The prevalence of ISR lesions with CN was 4.9%. Calcified lesions, incomplete stent apposition, haemodialysis, and female gender are probably associated with CN formation. ISR lesions with CN may have poor midterm outcomes compared with ISR lesions without CN.
钙化结节（CN）已被报道与支架失败相关，包括支架内再狭窄（ISR）。然而，目前尚缺乏对此情况的系统研究。
我们旨在阐明伴有 CN 的 ISR 病变的患病率、预测因素和中期结果。
我们检查了 2008 年 10 月至 2016 年 7 月期间接受经皮冠状动脉介入治疗（PCI）并接受光学相干断层扫描（OCT）检查的 651 例 ISR 病变患者的临床特征及其 6 至 8 个月的随访血管造影结果。CN 定义为向血管腔内突出的高背散射物质伴小的结节状钙沉积。
32 个 ISR 病变（4.9%）有 CN。多变量分析显示钙化病变（比值比[OR] 12.441，p<0.001）、不完全支架贴壁（OR 3.228，p=0.005）、血液透析（OR 3.633，p=0.024）和女性（OR 3.212，p=0.036）与伴有 CN 的 ISR 病变独立相关。对 612 例 ISR 病变进行了中期随访。与无 CN 的病变相比，伴有 CN 的病变的 ISR 和靶病变血运重建（TLR）率均显著升高（43.8%比 25.0%，p=0.023；37.5%比 18.8%，p=0.020）。然而，多变量分析并未显示 CN 的存在是再 TLR 的独立预测因子（OR 1.690，p=0.286）。
伴有 CN 的 ISR 病变的患病率为 4.9%。钙化病变、不完全支架贴壁、血液透析和女性可能与 CN 的形成有关。与无 CN 的 ISR 病变相比，伴有 CN 的 ISR 病变可能具有较差的中期结果。
