Abstract 9477: Relation Between Coronary Artery Calcium Score and Clinical Outcomes After Percutaneous Coronary Intervention in Stable Coronary Artery Disease

Abstract

Introduction: Recently, some consensus on high bleeding and thrombotic risk has been reported in the management of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, none of the currently available risk scores includes coronary artery calcification (CAC) score. The usefulness of the assessment of coronary artery calcium on the net adverse clinical event (NACE) in patients with stable CAD undergoing PCI remains understudied. This study aimed to evaluate the association between the CAC score measured by multidetector computed tomography (MDCT) and clinical outcomes after percutaneous coronary intervention (PCI) in stable CAD patients. Methods: We conducted a retrospective observational study including 134 consecutive patients who underwent MDCT and were scheduled for the first elective PCI. The patients were divided into 2 groups based on the CAC score [low (≤ 400) and high (> 400) CAC score]. High bleeding risk was assessed using the Academic Research Consortium for high bleeding risk (ARC-HBR) and the Japanese Circulation Society High Bleeding Risk (JCS-HBR) criteria. The clinical outcome was NACE that was defined as a composite of all-cause death, myocardial infarction (MI), stroke, target lesion revascularization (TLR), stent thrombosis, and major bleeding. According to the Bleeding Academic Research Consortium (BARC) definition, major bleeding was defined as BARC 3 and 5. Results: The high CAC score group was significantly associated with NACE than the low CAC group (22.0% vs 7.5%, P = 0.019). The Cox regression analyses showed that CAC score but not HBR-positive was a significant prognostic factor for NACE (HR, 3.27; 95% CI, 1.14-10.4; p < 0.028, HR, 1.12; 95% CI, 0.37-3.21; p = 0.834, respectively). The Kaplan-Meier survival curves showed that the high CAC group had a higher frequency of NACE events compared with the low CAC group (p = 0.012). Conclusions: The association of high CAC score with NACE including thrombotic and bleeding events were observed in patients with stable CAD, indicating that high CAC was independently related to being a predictor for NACE after PCI.