Long-term outcomes in patients with chronic coronary artery disease undergoing percutaneous coronary intervention of calcified lesions with angiographic visible calcium

Background Calcified coronary lesions are frequently seen in patients with comorbidities and pose a higher risk of complications during percutaneous coronary intervention (PCI). Purpose To evaluate the risk of acute myocardial infarction (MI) and all-cause mortality in patients with and without calcified lesions in patients with chronic coronary artery disease. Methods Demographic, clinical, and procedural data were extracted from the Western Denmark Heart Registry (WDHR) for individuals with chronic coronary artery disease undergoing PCI from January 2000 to January 2021. Major exclusion criteria were prior MI and PCI. Patients were categorized according to presence of calcified lesions defined as visible calcium on angiography during the index procedure. The endpoint was MI and all-cause mortality. Results In total, 16,757 patients underwent PCI due to chronic coronary artery disease of whom 5,302 (32.6 %) patients had calcified lesions and 11,455 (68.4 %) patients had lesions without calcium. Patients with calcified lesions had significantly higher absolute 5-year risk of MI (15.6% (n= 826)) compared to patients without calcified lesions (12.8% (n= 1469)) (p < 0.0005). Patients with calcified lesions had significantly higher absolute 5-year risk for all-cause mortality (13.6% (n = 720)) compared to patients without calcified lesions (8.6% (n = 984)) (p < 0.0005). Conclusion PCI of calcified lesions was associated with higher 5-year risk of MI and all-cause mortality.