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This study sought to identify whether coronary artery calcium score (CCS) is associated with procedure complexity, procedure-related complications and long-term clinical outcomes in patients with stable angina pectoris (SAP) underwent multivessel percutaneous coronary intervention (PCI).
145 SAP patients (male/female, 103/42; age, 65±10 years) who underwent first multivessel PCI following multi-detector computed tomography (MDCT) were enrolled. We standardized MDCT results into 3 CCS categories (0 to 100, 101 to 400, and >400) according to recent guidelines. Complex PCI was defined as use of high pressure balloon, kissing balloon and/or rotablator. Procedure-related complications included target artery occlusion, dissection, perforation, no/slow flow and emergency coronary artery bypass grafting. Main adverse cardiac events (MACE) were defined as a combined end point of death, non-fatal myocardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events.
As compared with the patients with CCS≤ 100 (n=39), those patients with CCS 101 to 400 (n=41) and CCS >400 (n=65) had significantly higher PCI procedure complexity (20.5% vs 46.3% vs 38.5, p = 0.040). And patients with CCS>400 (n=65) had a higher rate of procedure-related complications than patients with CCS <184>400 (n=80) (26.2% vs 6.3%, p = 0.001). Three patients (0.02%) were missed during a median of 21 months' (1 ∼ 69 months) follow-up. Kaplan-Meier survival analysis showed that patients with CCS 0 to 100, 101 to 400 and >400 had similar cumulative non-events survival rates (89.5% vs 82.4% vs 75.0%, p = 0.342). However, it showed significant different cumulative non-events survival rates in female subgroup (100% vs 83.3% vs 58.8%, Log rank 6.005, p = 0.049).
Preprocedural CCS assessment by MDCT indicates complexity of PCI and procedure-related complications in patients with SAP underwent multivessel PCI. CCS is more relevant with MACE in female patients.
- 2013 American College of Cardiology Foundation