Ebrahimi Mahmoud, Askari Vahid Reza, Sharifi Shima, Tabatabaei Seyed Mohammad, Rahmani Majid, Baradaran Rahimi Vafa
Department of Cardiovascular Diseases, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran.
International UNESCO Center for Health-Related Basic Sciences and Human Nutrition Mashhad University of Medical Sciences Mashhad Iran.
Health Sci Rep. 2023 Sep 28;6(10):e1588. doi: 10.1002/hsr2.1588. eCollection 2023 Oct.
Coronary artery calcification reduces elasticity and can cause hemodynamic disturbances, increasing the risk of cardiovascular complications. Furthermore, coronary calcifications make cardiovascular interventions difficult. The present study aimed to study the cardiovascular outcomes of the coronary intervention of calcified lesions in the Iranian population.
The present cross-sectional study evaluated patients with moderate to severe calcified coronary artery lesions on angiography who were candidates for percutaneous coronary intervention (PCI). Demographic, echocardiographic, and angiographic data of the patients were recorded. In addition, clinical outcomes, including mortality, myocardial infarction, stroke, and stent thrombosis, were also measured 1 year after the procedure.
A total of 125 participants (65% male and 35% female) with a median age of 69 (13.0) years old were enrolled. The most common calcification degree was 270° (43.5%), followed by 360° (35.5%) and 180° (21.0%). Most patients had thrombolysis in myocardial infarction (TIMI) score of 3 (47.6%). A more than 10% residual coronary minimum lumen diameter was seen in 25.8% of patients. Puncture site hemorrhage and contrast-induced nephropathy were observed in 2 (1.6%) and 1 (0.8%) patients, respectively. Following 1 year after PCI, no cases of mortality, cerebrovascular accident, myocardial infarction, and stent thrombosis were reported. Furthermore, we observed one case of heart failure (0.8%) and target lesion revascularization (0.8%). In addition, we revealed a significant relationship between calcification degree and TIMI ( < 0.001) and body mass index ( = 0.049).
Percutaneous management of calcified lesions with noncompliant balloon and one or two guidewires was associated with a good success rate and few complications.
冠状动脉钙化会降低弹性并可能导致血流动力学紊乱，增加心血管并发症的风险。此外，冠状动脉钙化会使心血管介入治疗变得困难。本研究旨在探讨伊朗人群中钙化病变冠状动脉介入治疗的心血管结局。
本横断面研究评估了血管造影显示有中度至重度冠状动脉钙化病变且适合经皮冠状动脉介入治疗（PCI）的患者。记录患者的人口统计学、超声心动图和血管造影数据。此外，还在术后1年测量临床结局，包括死亡率、心肌梗死、中风和支架血栓形成。
共纳入125名参与者（男性占65%，女性占35%），中位年龄为69（13.0）岁。最常见的钙化程度为270°（43.5%），其次是360°（35.5%）和180°（21.0%）。大多数患者的心肌梗死溶栓（TIMI）评分为3（47.6%）。25.8%的患者冠状动脉最小管腔直径残余超过10%。分别有2名（1.6%）和1名（0.8%）患者出现穿刺部位出血和造影剂肾病。PCI术后1年，未报告死亡、脑血管意外、心肌梗死和支架血栓形成病例。此外，我们观察到1例心力衰竭（0.8%）和靶病变血运重建（0.8%）。此外，我们发现钙化程度与TIMI（<0.001）和体重指数（=0.049）之间存在显著关系。
使用非顺应性球囊和一根或两根导丝对钙化病变进行经皮处理成功率高且并发症少。
