Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Previous intracoronary imaging studies have shown that coronary artery calcium (CAC) is an independent risk factor of stent underexpansion; however, limited preintervention assessments of CAC have been performed using noninvasive methods. We aimed to determine the association between lesion-specific CAC score and stent underexpansion. Methods: In this retrospective observational study, we included 416 lesions from 359 patients who underwent intravascular ultrasound (IVUS)-guided stent implantation. CAC of each lesion was quantified using the Agatston method derived from either nongated noncontrast chest CT (NCCT) or electrocardiogram-gated coronary CT angiography (CCTA). The primary endpoint was stent underexpansion defined as minimum stent area of <80% of the average reference lumen area. Results: < 0.05). The optimal cutoff values of lesion-specific CAC score to predict stent underexpansion were >200 in both NCCT (sensitivity, 91.4%; specificity, 66.8%) and CCTA (sensitivity, 84.6%; specificity, 64.3%) cohort, which were associated with 24.94-fold increased risk of stent underexpansion in NCCT cohort and 13.56-fold increased risk of stent underexpansion in CCTA cohort. Conclusions: In this study, we found that lesion-specific CAC scores in both NCCT and CCTA cohorts were significantly independently associated with an increased risk of stent underexpansion, and the cutoff value to predict stent underexpansion was >200.
Authors: Wentao Yang, Ke Xu, Xi Fu, Weifeng Zhang, Ziyong Hao, Zhenchi Sang, Lisheng Jiang, Xingbiao Qiu, Shengxian Tu, Linghong Shen, Ben He
Institutions: Shanghai Jiao Tong University, Shanghai Chest Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4407115153