Key result
Superficial calcification clusters are linked to ~69% higher MACE risk after carotid artery stenting.
Why the study?
The prognostic role of target plaque calcification in patients with carotid atherosclerosis undergoing carotid artery stenting was contradictory.
Does the amount of superficial calcification clusters in the target carotid plaque increase the risk of major adverse cardiovascular events in patients with carotid stenosis undergoing carotid artery stenting?
Cohort (n=211)
Neuroradiologists assessing carotid plaque characteristics on CTA were blind to clinical information of subjects
No
Does the amount of superficial calcification clusters in the target carotid plaque increase the risk of major adverse cardiovascular events in patients with carotid stenosis undergoing carotid artery stenting?
The number of superficial calcification clusters (particularly ≥4 clusters) on preoperative CTA is an independent predictor of long-term MACE after carotid artery stenting and may help guide selection between CAS and carotid endarterectomy.
Answers are grounded in this paper and cite their sources.
Superficial calcification clusters were associated with higher post-CAS MACE; extends prior calcification observations but leaves clinical utility open.
Background The role of calcification in carotid atherosclerosis before and after carotid artery stenting (CAS) is contradictory. This study assessed the relationship between the extent of calcification in target carotid plaque and the prognosis of patients with carotid stenosis undergoing carotid artery stenting. Methods A total of 293 subjects with carotid stenosis after CAS were consecutively and retrospectively recorded in this cohort. All subjects underwent outpatient and telephone follow-up using major adverse cardiovascular event (MACE). Finally, 211 subjects who completed 2-year follow-up were included. χ2 test, Student’s t-test and Wilcoxon test was used between MACE and no-MACE groups. Cox proportional hazard models were used to figure out the risk factor of calcification characteristics. Result Over a median follow-up period of 1.92 years, 14 composite endpoints were recorded. The symptom status (P = 0.0116), abuse of alcohol (P = 0.0091), the amount of total calcification clusters (P = 0.0428) and superficial calcification clusters (P = 0.0022) showed statistics significance in univariable Cox models. After adjusting for demographic characteristics and surgical-related factors, the amount of superficial calcification clusters maintained its statistical significance [P = 0.0232, hazard ratio (HR) = 1.694, 95% CI (confidence interval): 1.0744–2.6720]. Conclusion The present study established that the amount of superficial calcification clusters independently serves as a prognostic risk factor in patients with carotid atherosclerosis underwent carotid artery stenting.
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Zhu et al. (2026) conducted a cohort in Carotid artery stenosis undergoing carotid artery stenting (CAS) (n=211). Amount of superficial calcification clusters in target carotid plaque vs. Fewer superficial calcification clusters (<4 vs ≥4 clusters, or per cluster increase) was evaluated on Major adverse cardiovascular events (MACE: composite of nonfatal bilateral stroke, nonfatal myocardial infarction, and all-cause death occurring 30 days after discharge) (HR 1.694, 95% CI 1.0744-2.6720, p=0.0232). Increased superficial calcification clusters independently predicted higher major adverse cardiovascular events after carotid artery stenting (HR 1.694, 95% CI 1.0744-2.6720, P=0.0232).
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