Prognostic Value of lesion specific Calcium Score in Elective Percutaneous Coronary Intervention

Azza Alaa Ali Omran


In the evaluation of patients with suspected coronary artery disease (CAD), the role of non-invasive imaging has increased exponentially over the past decades, particularly in patients with an intermediate likelihood of CAD. Non-invasive imaging plays an important role in risk stratification and selection of further treatment strategies. More recently, multi-slice computed tomography (MSCT) has been proposed as an alternative imaging modality for evaluation of patients with suspected CAD. Calcified lesions provide a challenge in terms of both assessment and management. Vessel overlap, foreshortening, beam attenuation (particularly in obese patients), and under opacification may hinder accurate assessment of the anatomy. Optimal immediate results of stent implantation are crucial to decrease the risk of complications and improve long-term outcome even in the drug-eluting stent era. The current study aimed to identify both short and long term prognostic value of lesion specific CAC score and its parameters after target lesion stenting. In our study we assessed 56 patients (with 64 lesions) presented to evaluate symptoms of chest pain with low or intermediate likelihood of having coronary artery disease Patients by MSCT CA as a part of their diagnostic process and found to have significant lesion with calcification. Patients having one or more of the following criteria were excluded from the study: prior (PCI), cardiogenic shock, CABG, Recent ACS, Inadequate image quality, CHD, and patients with impaired kidney functions. All patients were subjected to proper history taking, thorough clinical examination, ECG, echocardiography, serum creatinine measurement then adequate preparation before MSCT and PCI by good hydration and clopidogrel. MSCT was done using a dual source machine with interpretation of all data regarding affected segment lesion specific CAC score, lesion calcium thickness, length and area. PCI later was done by experienced operators and all the procedure variables were registered. Patients were followed up for procedural outcome, periprocedural complication and long term complications. We found significant statistical correlation between advanced age, DM and multivessel disease and increase total Agatston score and lesion specific CAC score. Also, significant statistical correlation between lesion specific calcium parameters in term of calcium length, thickness and area (especially calcium area) and the need of high balloon pressure, stent inflation pressure and post deployment dilatation pressure.

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Other Titles التكلس المحدد في ضيق الشريان التاجي كمؤشر للنتائج السلبية لقسطرة القلب التداخلية
Issue Date 2016

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