Cardiac outcomes in patients with acute coronary syndrome attributable to calcified nodule

Sugane, Hiroki; Kataoka, Yasufumi; Otsuka, Fumiyuki; Nakaoku, Yuriko; Nishimura, Kunihiro; Nakano, Hiroki; Murai, Kota; Honda, Satoshi; Hosoda, Hayato; Matama, Hideo; Doi, Takahito; Nakashima, Takahiro; Fujino, Masashi; Nakao, Kazuhiro; Yoneda, Shuichi; Terada, Yoshio; Asaumi, Yasuhide; Noguchi, Teruo; Kawai, Kensuke; Yasuda, Satoshi

doi:10.1016/j.atherosclerosis.2020.11.005

Cited by 54 publications

(48 citation statements)

References 16 publications

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“…In summary, Sugene et al [2] showed that the clinical course of patients with CN who undergo PCI and the mechanisms of failure were due to ACS caused by the reappearance of in-stent CN. However, there are many unsolved problems and further studies are needed to improve clinical outcomes in patients with CN.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

See 1 more Smart Citation

Calcified nodule: A rare but important cause of acute coronary syndrome with worse clinical outcomes

Sato¹,

Finn²,

Virmani³

2021

Atherosclerosis

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Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

“…In this issue of Atherosclerosis, Sugene et al retrospectively analyzed clinical outcomes in patients with ACS attributed to CN [2]. The authors evaluated 657 ACS patients receiving percutaneous coronary intervention (PCI) with newer-generation drug-eluting stent (DES) under intravascular ultrasound (IVUS) guidance in their institution.…”

mentioning

confidence: 99%

Calcified nodule: A rare but important cause of acute coronary syndrome with worse clinical outcomes

Sato¹,

Finn²,

Virmani³

2021

Atherosclerosis

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“…PCI for a calcified nodule is challenging despite advances in coronary intervention procedures. Previously, we reported that acute coronary syndrome attributable to a calcified nodule was associated with an increased risk of target lesion revascularization [ 5 ]. Furthermore, the bifurcation two-stent strategy was associated with higher rates of target lesion revascularization and stent thrombosis than the one-stent strategy [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Heart Team Intervention for Calcified Left Main Coronary Disease and Jeopardized Left Internal Mammary Artery Graft

Tomura

Fujino

Kataoka

et al. 2022

Case Reports in Cardiology

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It is sometimes difficult to identify the culprit lesion and treatment strategy in patients with acute coronary syndrome who have complex coronary lesions and jeopardized left internal mammary artery graft. This report describes a heart team approach for a non-ST-segment elevation myocardial infarction case with complex coronary vasculature. A 73-year-old man presented to the emergency department with crescendo angina. He had a history of total aortic arch replacement with concomitant coronary artery bypass graft using left internal mammary artery. Emergent coronary angiography demonstrated severe stenosis at left main trunk bifurcation caused by calcified nodule. While the bypass graft to left anterior descending coronary artery was patent, the proximal segment of left subclavian artery was occluded. Following the prompt discussion with our heart team, we performed percutaneous coronary intervention in the first step for treating the left main stenosis using rotational atherectomy into the unprotected left circumflex artery. After clinical recovery, stress myocardial scintigraphy identified the presence of anteroseptal ischemia, which indicated coronary subclavian steal syndrome due to left subclavian artery occlusion. Contrast-enhanced CT visualized that the occlusion originated from the anastomosis, suggesting the potential procedural risk of endovascular treatment by dilatation. Our heart team discussed again and decided to undergo axillo-axillary artery bypass surgery. He was discharged 8 days after the surgery without any sequelae. This is the rare case report of non-ST-segment elevation myocardial infarction who had similar condition to coronary subclavian steal syndrome after total aortic arch replacement. This case highlights the importance of a collaborative approach of the heart team to identify the best therapeutic strategy in a patient with complex coronary vasculature.

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“…Quantitative coronary angiography analysis included minimal lumen diameter, percent diameter stenosis, lesion length, and reference vessel diameter. 17…”

Section: Methodsmentioning

confidence: 99%

“…Quantitative coronary angiography analysis included minimal lumen diameter, percent diameter stenosis, lesion length, and reference vessel diameter. 17 All patients were evaluated using IVUS before the procedure. After intracoronary administration of .1-.2 mg nitroglycerin, IVUS images (Altaview; Terumo, Tokyo, Japan or Opticross; Boston Scientific, MA, USA) were obtained with automated pullback (1.0 mm/s) before balloon dilatation.…”

Section: Angiographic Findings and Ivus Evaluationmentioning

confidence: 99%

Impact of Hemodialysis Duration on Coronary Artery Calcification Among Hemodialysis Patients Who Underwent Percutaneous Coronary Intervention

et al. 2022

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Our study aimed to evaluate the prevalence and impact of coronary artery calcification (CAC) on hemodialysis (HD) patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We enrolled 211 HD patients who underwent PCI (men: n = 155, age: 71 ± 1 0 years). Severe CAC was defined as calcification with an arc of 360° on intravascular ultrasound. Multivariate analysis was performed to determine the predictors of severe CAC. The impact of severe CAC on target lesion revascularization (TLR) was evaluated. Patients with severe CAC (46%) had a higher incidence of diabetes mellitus (DM) (79 vs 59%, P = .003) and longer HD duration (7.7 vs 3.4 years, P < .001) than those with non-severe CAC. Multivariate analysis demonstrated that DM, HD duration, and angiographic calcification were significant predictors for severe CAC (odds ratio 4.42, 1.13, and 6.62; P < .001, P < .001, and P < .001, respectively). After the median follow-up period of 580 days (interquartile range, 302–730 days), Kaplan–Meier curve analysis revealed that severe CAC was associated with an increased risk for TLR (χ2 12.7; P = .002). In HD patients with CAD after PCI, DM and HD duration were significant predictors for severe CAC. Furthermore, severe CAC was associated with an increased risk for TLR.

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Cardiac outcomes in patients with acute coronary syndrome attributable to calcified nodule

Cited by 54 publications

References 16 publications

Calcified nodule: A rare but important cause of acute coronary syndrome with worse clinical outcomes

Calcified nodule: A rare but important cause of acute coronary syndrome with worse clinical outcomes

Heart Team Intervention for Calcified Left Main Coronary Disease and Jeopardized Left Internal Mammary Artery Graft

Impact of Hemodialysis Duration on Coronary Artery Calcification Among Hemodialysis Patients Who Underwent Percutaneous Coronary Intervention

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