Lesion-specific coronary artery calcium score to predict stent underexpansion
BackgroundPrevious 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 lesio...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1524390/full |
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| author | Wentao Yang Ke Xu Xi Fu Weifeng Zhang Ziyong Hao Zhenchi Sang Lisheng Jiang Xingbiao Qiu Shengxian Tu Linghong Shen Ben He |
| author_facet | Wentao Yang Ke Xu Xi Fu Weifeng Zhang Ziyong Hao Zhenchi Sang Lisheng Jiang Xingbiao Qiu Shengxian Tu Linghong Shen Ben He |
| author_sort | Wentao Yang |
| collection | DOAJ |
| description | BackgroundPrevious 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.MethodsIn 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.ResultsOverall, stent underexpansion occurred in 144 (34.6%) of 416 lesions. Lesion-specific CAC score was significantly negatively correlated with the stent expansion rate (in NCCT cohort, r = 0.8113, P < 0.05; in CCTA cohort, r = 0.8024, P < 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.ConclusionsIn 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. |
| format | Article |
| id | doaj-art-dfc319d3d36541c5aa8b654775963832 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-dfc319d3d36541c5aa8b6547759638322025-02-04T06:32:06ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-02-011210.3389/fcvm.2025.15243901524390Lesion-specific coronary artery calcium score to predict stent underexpansionWentao Yang0Ke Xu1Xi Fu2Weifeng Zhang3Ziyong Hao4Zhenchi Sang5Lisheng Jiang6Xingbiao Qiu7Shengxian Tu8Linghong Shen9Ben He10Department of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaBiomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaBackgroundPrevious 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.MethodsIn 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.ResultsOverall, stent underexpansion occurred in 144 (34.6%) of 416 lesions. Lesion-specific CAC score was significantly negatively correlated with the stent expansion rate (in NCCT cohort, r = 0.8113, P < 0.05; in CCTA cohort, r = 0.8024, P < 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.ConclusionsIn 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.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1524390/fullcoronary artery calcium scorepercutaneous coronary interventioncoronary computed tomography angiographynon-gated non-contrast chest computed tomographystent expansion |
| spellingShingle | Wentao Yang Ke Xu Xi Fu Weifeng Zhang Ziyong Hao Zhenchi Sang Lisheng Jiang Xingbiao Qiu Shengxian Tu Linghong Shen Ben He Lesion-specific coronary artery calcium score to predict stent underexpansion Frontiers in Cardiovascular Medicine coronary artery calcium score percutaneous coronary intervention coronary computed tomography angiography non-gated non-contrast chest computed tomography stent expansion |
| title | Lesion-specific coronary artery calcium score to predict stent underexpansion |
| title_full | Lesion-specific coronary artery calcium score to predict stent underexpansion |
| title_fullStr | Lesion-specific coronary artery calcium score to predict stent underexpansion |
| title_full_unstemmed | Lesion-specific coronary artery calcium score to predict stent underexpansion |
| title_short | Lesion-specific coronary artery calcium score to predict stent underexpansion |
| title_sort | lesion specific coronary artery calcium score to predict stent underexpansion |
| topic | coronary artery calcium score percutaneous coronary intervention coronary computed tomography angiography non-gated non-contrast chest computed tomography stent expansion |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1524390/full |
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