Key result
New calcified nodules in untreated calcified lesions were associated with more frequent revascularisation and/or myocardial infarction compared to lesions without new nodules (29.3% vs 15.3%; p=0.04).
Why the study?
Calcified nodules are an increasingly important, high-risk lesion subset, but the emergence of new calcified nodules and their relationship with underlying plaque characteristics remained to be identified.
Cohort
Absolute Event Rate: 29.3% vs 15.3%
p-value: p=0.04
The development of new calcified nodules in untreated calcified lesions is predicted by calcium volume and angiographic hinge motion, and is associated with a higher risk of subsequent myocardial infarction or revascularization.
BACKGROUND: Calcified nodules (CNs) are an increasingly important, high-risk lesion subset. AIMS: We sought to identify the emergence of new CNs and the relation between underlying plaque characteristics and new CN development. METHODS: Patients who had undergone two optical coherence tomography (OCT) studies that imaged the same untreated calcified lesion at baseline and follow-up were included. New CNs were an accumulation of small calcium fragments at follow-up that were not present at baseline. Cardiac death, myocardial infarction (MI), or clinically driven revascularisation related to OCT-imaged, but untreated, calcified lesions were then evaluated. RESULTS: calcium volume index (length×maximum arc×maximum thickness; OR 2.76, 95% CI: 1.10-6.95; p=0.03); angiographic Δangle between systole and diastole, per 10° (OR 2.30, 95% CI: 1.25-4.22; p=0.01); and time since baseline OCT, per year (OR 1.36, 95% CI: 1.05-1.75; p=0.02) were all associated with new CN development. Clinical events were revascularisation and/or MI and were more frequent in lesions with versus without a new CN (29.3% vs 15.3%; p=0.04). CONCLUSIONS: New CNs developed in untreated, lipid-containing, severely calcified lesions with a larger angiographic hinge motion (between systole and diastole), compared with lesions without CNs, and were associated with worse clinical outcomes.
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Sugizaki et al. (2024) conducted a cohort in Untreated calcified lesions. New calcified nodule development vs. Lesions without new calcified nodules was evaluated on Revascularisation and/or myocardial infarction (p=0.04). New calcified nodules in untreated calcified lesions were associated with more frequent revascularisation and/or myocardial infarction compared to lesions without new nodules (29.3% vs 15.3%; p=0.04).
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