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Kurniawan RB, Saputra PBT, Haq AUDU, Purwati DD, Wungu CDK, Susilo H, Alsagaff MY, Amin IM, Oktaviono YH. Characteristics of calcified nodule attributable to culprit lesion in acute coronary syndrome: A systematic review and meta-analysis. iScience 2024; 27:110351. [PMID: 39092174 PMCID: PMC11292520 DOI: 10.1016/j.isci.2024.110351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/01/2024] [Accepted: 06/20/2024] [Indexed: 08/04/2024] Open
Abstract
The presence of calcified nodule (CN) is a significant characteristic of atherothrombosis in acute coronary syndrome (ACS). However, its characteristics continue to be understudied. This review aimed to further investigate these characteristics. This study found that CN was a distinctive feature of an atheromatous plaque, representing 6.3% of ACS. CN was more common in NSTE-ACS than in STEMI patients (9.4% vs. 6.6%). CN was also chiefly observed in the left anterior descendant artery (48%), followed by the right coronary (40.4%) and left circumflex (14.5%) arteries. Higher prevalence of hypertension (78.8%), diabetes mellitus (50.8%), multivessel disease (71.7%), and kidney disease (26.43%) were noted in CN compared to non-CN patients. CN-associated ACS also 6-fold increased the risk of target lesion revascularization compared to those without CN.
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Affiliation(s)
| | - Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | | | | | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Indah Mohd Amin
- Center of Preclinical Science Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor Darul Ehsan, Malaysia
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Oliveira C, Vilela M, Nobre Menezes M, Silva Marques J, Jorge CM, Rodrigues T, Almeida Duarte J, Marques da Costa J, Carrilho Ferreira P, Francisco AR, Cardoso PP, Pinto FJ. Coronary Intravascular Lithotripsy Effectiveness and Safety in a Real-World Cohort. J Pers Med 2024; 14:438. [PMID: 38673064 PMCID: PMC11051019 DOI: 10.3390/jpm14040438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/16/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Coronary artery calcification is a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Intravascular lithotripsy (IVL) is a promising tool for the treatment of calcified lesions. The aim of this study was to assess the effectiveness and safety of IVL. Methods: A single-center observational study of PCI procedure, with assessment of the outcomes of patients undergoing PCI using IVL, was performed. Angiographic procedural success was used as the primary effectiveness endpoint. The primary safety endpoint was defined as a composite of cardiac death, myocardial infarction and target vessel revascularization within 30 days. Results: A total of 111 patients were included. Indications for PCI spanned the spectrum of chronic (53.2%) and acute coronary syndromes (43%). Lesion preparation before IVL was performed with non-compliant (42%), cutting or OPN (14.4%) balloons and with atherectomy techniques in 11% of procedures. Intravascular imaging was used in 21.6% of procedures. The primary effectiveness endpoint was achieved in 100% and the primary safety endpoint in 3.6% of procedures. Peri-procedural complications were minimal and successfully resolved. Conclusions: IVL was an effective and safe technique for the treatment of calcified coronary lesions. These findings contribute to the growing body of evidence supporting the use of IVL in the management of these challenging scenarios.
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Affiliation(s)
- Catarina Oliveira
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Marta Vilela
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Miguel Nobre Menezes
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - João Silva Marques
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Cláudia Moreira Jorge
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Tiago Rodrigues
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - José Almeida Duarte
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - José Marques da Costa
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Pedro Carrilho Ferreira
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Ana Rita Francisco
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Pedro Pinto Cardoso
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Fausto J. Pinto
- Serviço de Cardiologia, Departamento de Coração e Vasos, CHULN Hospital de Santa Maria, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Av Prof. Egas Moniz, 1649-028 Lisboa, Portugal
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3
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Nafee T, Shah A, Forsberg M, Zheng J, Ou J. State-of-art review: intravascular imaging in percutaneous coronary interventions. CARDIOLOGY PLUS 2023; 8:227-246. [PMID: 38304487 PMCID: PMC10829907 DOI: 10.1097/cp9.0000000000000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/05/2023] [Indexed: 02/03/2024] Open
Abstract
The history of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) reflects the relentless pursuit of innovation in interventional cardiology. These intravascular imaging technologies have played a pivotal role in our understanding of coronary atherosclerosis, vascular pathology, and the interaction of coronary stents with the vessel wall. Two decades of clinical investigations demonstrating the clinical efficacy and safety of intravascular imaging modalities have established these technologies as staples in the contemporary cardiac catheterization lab's toolbox and earning their place in revascularization clinical practice guidelines. In this comprehensive review, we will delve into the historical evolution, mechanisms, and technical aspects of IVUS and OCT. We will discuss the expanding evidence supporting their use in complex percutaneous coronary interventions, emphasizing their crucial roles in optimizing patient outcomes and ensuring procedural success. Furthermore, we will explore the substantial advances that have propelled these imaging modalities to the forefront of contemporary interventional cardiology. Finally, we will survey the latest developments in the field and explore the promising future directions that have the potential to further revolutionize coronary interventions.
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Affiliation(s)
- Tarek Nafee
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
| | - Areeb Shah
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
| | - Michael Forsberg
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
| | - Jingsheng Zheng
- Department of Cardiology, AtlantiCare Regional Medical Center, Pomona, NJ 08240, USA
| | - Jiafu Ou
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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