Background and Objectives: Treatment of calcified coronary arteries is associated with poorer angiographic results and higher rate of complications as compared with non-calcified arteries. Little is known about the impact of coronary calcification on outcomes after percutaneous coronary intervention (PCI) for patients presenting with acute myocardial infarction(AMI). We sought to determine the frequency and impact of coronary artery calcification(CAC) among patients undergoing primary PCI (PPCI) for STEMI.
Methods: We analyzed 2143 consecutive patients presenting to our hospital with STEMI and that underwent PPCI within 12 hours of chest pain. Patients were divided into two groups, one with moderate or severe CAC (14%) and the second without CAC. We analyzed their clinical characteristics and one year outcome including death, MI, Stent Thrombosis, Target Vessel Revascularization and MACE.
Results: Patients with CAC were older, sicker, and had poorer final angiographic results (see table). They had higher one year requirement for coronary artery bypass grafting (7.2% vs. 3.5%, p=0.003)
Patients without CAC had lower MACE rates (17.5% vs. 24%, p=0.01) driven by lower mortality (4.7% vs. 8.5%, p=0.008).
Conclusions: In STEMI PCI, CAC is associated with poorer angiographic and clinical outcomes compared with lesser or non-calcified coronary arteries.
Table:
|
p-Value
|
Calcified
(n=306)
|
Non-calcified
(n=1837)
|
Variables
|
|
0.001
|
±6813
|
12±59
|
Age
|
|
0.0001
|
74
|
84
|
Male (%)
|
|
0.08
|
30
|
25
|
Diabetes Mellitus (%)
|
|
0.0001
|
22
|
11
|
Renal Failure (%)
|
|
0.0001
|
61
|
43
|
Anterior MI (%)
|
|
0.001
|
70
|
57
|
Two/Three vessel disease(%)
|
|
0.001
|
17
|
11
|
Killip>1
|
|
0.0001
|
6.1±3.9
|
3.8±3.3
|
Cadillac score
|
|
0.0001
|
90
|
97
|
Final TIMI 3(%)
|
|
0.05
|
94
|
96
|
Stenting (%)
|
