Phenotypic Characterization and Spatial Distribution of Eruptive versus Non-Eruptive Calcified Nodules: A Comparative Multimodality Imaging Analysis

Q: What are the key findings of this study?

Eruptive calcified nodules exhibited higher lipid burden and mid-RCA clustering than non-eruptive nodules.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery calcified nodules (n=64). Intervention: Eruptive calcified nodule phenotype vs. Non-eruptive calcified nodule phenotype. Primary outcome: Maximum lipid core burden index in 4-mm segment (maxLCBI4mm) (OR 1.007, 95% CI 1.003-1.011, p=<0.001).

Q: What does this research mean for the field?

Eruptive calcified nodules exhibit significantly higher lipid burden and preferential clustering in the mid-right coronary artery compared to non-eruptive nodules. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Takumi Watanabe; Eisuke Usui; Yoshihisa Kanaji; Hiroki Ueno; Kodai Sayama; Takahiro Watanabe; Riko Murakami; Shunta Hiroi; Kaisei Hosokawa; Taishi Yonetsu; Tsunekazu Kakuta

doi:10.5551/jat.66356

January 1, 2026Journal of Atherosclerosis and ThrombosisOpen Access

Phenotypic Characterization and Spatial Distribution of Eruptive versus Non-Eruptive Calcified Nodules: A Comparative Multimodality Imaging Analysis

View Full Paper

Ask AI

Bookmark

Share

Key result

Eruptive calcified nodules carry substantially higher lipid burden and cluster in the mid-RCA vs non-eruptive nodules.

OR 1.007
95% CI 1.003-1.011
P<0.001
n=64

Why the study?

Although morphological differences between eruptive and non-eruptive calcified nodules have been noted, the interplay between plaque composition, spatial distribution, and eruption biomechanics across clinical presentations remains incompletely understood.

What plaque compositional profiles, morphological features, and spatial distributions distinguish eruptive from non-eruptive coronary calcified nodules on multimodality intravascular imaging (OCT and NIRS-IVUS)?

Study Design

Type

Observational (n=64)

Blinding

Blinded image analysis

Multicenter

No

Structured PICO

What plaque compositional profiles, morphological features, and spatial distributions distinguish eruptive from non-eruptive coronary calcified nodules on multimodality intravascular imaging (OCT and NIRS-IVUS)?

P

Population

64 patients (70 lesions) with coronary calcified nodules undergoing OCT-guided PCI with pre-procedural OCT and NIRS-IVUS imaging across acute and chronic coronary syndromes.

E

Exposure

Multimodality intravascular imaging using frequency-domain optical coherence tomography (OCT) and near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) prior to PCI, assessing eruptive calcified nodules (n=31 lesions).

C

Comparator

Non-eruptive calcified nodules (n=39 lesions) assessed by pre-PCI OCT and NIRS-IVUS.

O

Outcome

Phenotypic, compositional, and topographical characteristics associated with eruptive versus non-eruptive calcified nodules, including calcium architecture (maximum calcium angle, thickness, length, OCT-derived calcium score), lipid content (maximum lipid core burden index within a 4-mm segment, maxLCBI4mm), and anatomical distribution across the coronary tree.surrogate

Main Result

Odds Ratio: 1.007 (95% CI 1.003–1.011)

Absolute Event Rate: 318% vs 78%

p-value: p=<0.001

Eruptive coronary calcified nodules are independently associated with hemodialysis, higher adjacent lipid core burden (maxLCBI4mm), and mid-RCA location, supporting a 'two-hit' mechanism where a heavily calcified, lipid-rich plaque interacts with high biomechanical stress to promote eruption.

Limitations

Retrospective, single-center study with a relatively small sample size, limiting generalizability and precluding robust analysis of long-term clinical outcomes
Diagnosis was based on intravascular imaging criteria without histopathological confirmation
Cross-sectional design precluded observation of the temporal evolution of lesions
Selection bias is inherent as all patients were referred for PCI and NIRS-IVUS was performed at the operator's discretion

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Warrants caution against routine clinical adoption of nodule phenotyping; leaves open prospective validation of eruptive features for risk prediction.

Abstract

Aim: Calcified nodules (CNs) represent a high-risk morphological subset of coronary atherosclerosis, categorized into eruptive and non-eruptive subtypes. Although previous studies have noted morphological differences, the interplay between plaque composition, spatial distribution, and eruption biomechanics across clinical presentations remains incompletely understood.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Watanabe et al. (2026) conducted an observational in Coronary artery calcified nodules (n=64). Eruptive calcified nodule phenotype vs. Non-eruptive calcified nodule phenotype was evaluated on Maximum lipid core burden index in 4-mm segment (maxLCBI4mm) (OR 1.007, 95% CI 1.003-1.011, p=<0.001). Eruptive calcified nodules exhibited higher lipid burden and mid-RCA clustering than non-eruptive nodules.

synapsesocial.com/papers/6af9ebcdd393cbc380a04fcc https://doi.org/10.5551/jat.66356

View Full Paper

Ask AI

Bookmark

Share

Phenotypic Characterization and Spatial Distribution of Eruptive versus Non-Eruptive Calcified Nodules: A Comparative Multimodality Imaging Analysis

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Phenotypic Characterization and Spatial Distribution of Eruptive versus Non-Eruptive Calcified Nodules: A Comparative Multimodality Imaging Analysis

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading