Abstract
BackgroundCoronary calcification has been linked to cardiovascular events. We developed and validated an algorithm to automatically quantify coronary calcifications on intravascular ultrasound (IVUS). We aimed to assess the prognostic value of an IVUS-calcium score (ICS) on patient-oriented composite endpoint (POCE).MethodsWe included patients that underwent coronary angiography plus pre-procedural IVUS imaging. The ICS was calculated per patient. The primary endpoint was a composite of all-cause mortality, stroke, myocardial infarction, and revascularization (POCE).ResultsIn a cohort of 408 patients, median ICS was 85. Both an ICS ≥ 85 and a 100 unit increase in ICS increased the risk of POCE at 6-year follow-up (adjusted hazard ratio (aHR) 1.51, 95%CI 1.05–2.17, p value = 0.026, and aHR 1.21, 95%CI 1.04–1.41, p value = 0.014, respectively).ConclusionsThe ICS, calculated by a validated automated algorithm derived from routine IVUS pullbacks, was strongly associated with the long-term risk of POCE.Graphical abstract
Highlights
Calcification is the end result of apoptosis of smooth muscle cells and macrophages and proved to be associated with advanced stages of atherosclerosis [1]
A total of 308 (75.5%) vessels were subsequently treated with either percutaneous coronary intervention (PCI) (n=289; 70.1%) or coronary artery bypass grafting (CABG) (n=19; 4.7%) (Fig. 1)
Study vessels with an IVUS-calcium score (ICS) ≥ 85 were more often revascularized compared with vessels with an ICS < 85 (Table 1)
Summary
Calcification is the end result of apoptosis of smooth muscle cells and macrophages and proved to be associated with advanced stages of atherosclerosis [1]. Intravascular imaging techniques like intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have a higher sensitivity to detect coronary calcification but lack the ability to. We aimed to assess the prognostic value of an IVUS-calcium score (ICS) on patient-oriented composite endpoint (POCE). Results In a cohort of 408 patients, median ICS was 85. Both an ICS ≥ 85 and a 100 unit increase in ICS increased the risk of POCE at 6-year follow-up (adjusted hazard ratio (aHR) 1.51, 95%CI 1.05–2.17, p value = 0.026, and aHR 1.21, 95%CI 1.04– 1.41, p value = 0.014, respectively). Conclusions The ICS, calculated by a validated automated algorithm derived from routine IVUS pullbacks, was strongly associated with the long-term risk of POCE
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