Comparison of Outcomes After Percutaneous Coronary Intervention Between Calcified and Nonclacified Lesions

Abstract

AbstractIntroduction: Coronary artery calcification increases with age and associated with significant major adverse cardiovascular events. The presence of calcification makes the percutaneous coronary interventions difficult and associated with peri-procedural complications. The main objective of our study is to evaluate the outcome of patients with calcific coronary lesions compared with non-calcific lesions.Methods: Patients admitted in the cardiology department with either chronic stable angina or acute coronary syndrome who underwent percutaneous coronary interventions were included and divided into two groups, those who had calcific coronary lesions and non-calcific coronary lesions. Calcified lesions were made out by fluoroscopy during conventional angiogram as radiopacity at the site of the target lesion. We prospectively collected and compared the demographic, clinical data ( including risk factors), details of PCI procedure and in hospital outcomes(enzymatic infarcts - EI, vascular access complications –bleed or pseudo-aneurysm, contrast induced nephropathy - CIN, target vessel acute occlusion with or without heart failure – HF and mortality) between calcified and non-calcified lesions.Results: A total of 439 patients were enrolled in the study of which 283 patients were in a calcific group and 156 patients were in non-calcific group. There was no significant difference among risk factors like DM and HTN (p=0.92, p=0.59) in between the both groups. Calcific coronary lesions had long lesions (mean lesion length -20.01 ±3.8mm in calcific, 18.3±3.9mm in non-calcific: p= 0.00) requiring longer stents (mean stent size and length- 3.08 ± 2.1 mm, 22.12 ± 7.95mm in calcific and 2.92± 0.38 mm, 20.5 ± 7.3mm in non-calcific group) compared to non-calcific lesions, which was statistically significant (p=0.02). In hospital complications like EI, HF and pseudo-aneurysm were more in the non-calcific group (n=19, p=0.02), whereas vascular site bleeding was higher in the calcific group. There was no significant difference between mortality between these groups.Conclusion: There was no increased risk of in-hospital and peri-procedural complications in patients with calcific coronary artery lesions compared to non-calcific lesions, which also depends on other conditions like acuteness of presentation and left ventricular function.