背景:严重钙化冠状动脉病变的经皮冠状动脉介入治疗(PCI)具有挑战性。冠状动脉钙化结节(CN)是指与斑块易损性和不良临床事件相关的偏心和突出的冠状动脉钙化。这项研究旨在对CNs进行广泛的审查,与非结节性冠状动脉钙化(N-CN)相比,重点关注其预后影响。
方法:关于PubMed,MEDLINE,和EMBASE数据库进行了相关文章。纳入比较CNs和N-CNs的观察性研究或随机对照试验。
结果:五项比较CNs和N-CNs的研究与纳入相关。这些研究中的个体总数为1456。基线人口统计学没有显着差异,临床,CN和N-CN组之间的血管造影数据。冠状动脉成像始终被利用。在后续行动中,CNs显著增加,与N-CN相比,目标血管血运重建[比值比(OR)2.16;95%置信区间(CI):1.39-3.36,P值<0.01,I2=0%]和支架内血栓形成(OR9.29;95%CI:1.67-51.79,P值=0.01,I2=0%)。在CN组中还评估了更大的心脏死亡趋势(OR1.75;95%CI:0.98-3.13,P值=0.06,I2=0%)。
结论:与N-CN相比,CN对结局有显著的负面影响。
BACKGROUND: Percutaneous coronary intervention (PCI) on severely calcified coronary lesions is challenging. Coronary calcified nodule (CN) refers to an eccentric and protruding coronary calcification associated with plaque vulnerability and adverse clinical events. This study aims to conduct an extensive
review of CNs, focusing on its prognostic impact in comparison with nonnodular coronary calcification (N-CN).
METHODS: A systematic literature
review on PubMed, MEDLINE, and EMBASE databases was conducted for relevant articles. Observational studies or randomized controlled trials comparing CNs and N-CNs were included.
RESULTS: Five studies comparing CNs and N-CNs were pertinent for inclusion. The total number of individuals across these studies was 1456. There were no significant differences in the baseline demographic, clinical, and angiographic data between the CN and N-CN groups. Intracoronary imaging was always utilized. At follow-up, CNs were associated with significantly increased, target vessel revascularization [odds ratio (OR) 2.16; 95% confidence interval (CI): 1.39-3.36, P-value < 0.01, I2 = 0%] and stent thrombosis (OR 9.29; 95% CI: 1.67-51.79, P-value = 0.01, I2 = 0%) compared with N-CN. A trend for greater cardiac death was also assessed in the CN group (OR 1.75; 95% CI: 0.98-3.13, P-value = 0.06, I2 = 0%).
CONCLUSIONS: CN has a significantly negative impact on outcomes when compared with N-CN.