AI Article Synopsis

  • Calcified nodules (CNs) are high-risk lesions that can emerge from untreated calcified lesions, leading to serious health issues like cardiac death and myocardial infarction.
  • A study with 372 patients tracked the development of new CNs over approximately 1.5 years, finding that 7% of lesions showed new CNs at follow-up.
  • Factors like the presence of residual lipid, larger calcified volume, increased motion during heart cycles, and longer time since initial imaging were linked to the formation of new CNs and were associated with worse clinical outcomes.

Article Abstract

Background: Calcified nodules (CNs) are an increasingly important, high-risk lesion subset.

Aims: We sought to identify the emergence of new CNs and the relation between underlying plaque characteristics and new CN development.

Methods: Patients who had undergone two optical coherence tomography (OCT) studies that imaged the same untreated calcified lesion at baseline and follow-up were included. New CNs were an accumulation of small calcium fragments at follow-up that were not present at baseline. Cardiac death, myocardial infarction (MI), or clinically driven revascularisation related to OCT-imaged, but untreated, calcified lesions were then evaluated.

Results: Among 372 untreated calcified lesions, with a median of 1.5 (first and third quartiles: 0.7-2.9) years between baseline and follow-up OCTs, new CNs were observed in 7.0% (26/372) of lesions at follow-up. Attenuated calcium representing residual lipid (odds ratio [OR] 3.38, 95% confidence interval [CI]: 1.15-9.98; p=0.03); log calcium volume index (length×maximum arc×maximum thickness; OR 2.76, 95% CI: 1.10-6.95; p=0.03); angiographic Δangle between systole and diastole, per 10° (OR 2.30, 95% CI: 1.25-4.22; p=0.01); and time since baseline OCT, per year (OR 1.36, 95% CI: 1.05-1.75; p=0.02) were all associated with new CN development. Clinical events were revascularisation and/or MI and were more frequent in lesions with versus without a new CN (29.3% vs 15.3%; p=0.04).

Conclusions: New CNs developed in untreated, lipid-containing, severely calcified lesions with a larger angiographic hinge motion (between systole and diastole), compared with lesions without CNs, and were associated with worse clinical outcomes.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522861PMC
http://dx.doi.org/10.4244/EIJ-D-24-00362DOI Listing

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