Coronary calcification in patients presenting with acute coronary syndromes: insights from the MATRIX trial

被引：2

作者：

Sanz-Sanchez, Jorge ^{[1
,2
]}

Garcia-Garcia, Hector M. ^{[3
]}

Branca, Mattia

Frigoli, Enrico ^{[4
]}

Leonardi, Sergio ^{[5
,6
]}

Gagnor, Andrea ^{[7
]}

Calabro, Paolo ^{[8
,9
]}

Garducci, Stefano ^{[10
]}

Rubartelli, Paolo ^{[11
]}

Briguori, Carlo ^{[12
]}

Ando, Giuseppe ^{[13
]}

Repetto, Alessandra ^{[5
,6
]}

Limbruno, Ugo ^{[14
]}

Garbo, Roberto ^{[15
]}

Sganzerla, Paolo ^{[16
]}

Russo, Filippo ^{[17
]}

Lupi, Alessandro ^{[18
]}

Cortese, Bernardo ^{[19
]}

Ausiello, Arturo ^{[20
]}

Ierna, Salvatore ^{[21
]}

Esposito, Giovanni ^{[22
]}

Santarelli, Andrea ^{[23
]}

Sardella, Gennaro ^{[24
]}

Varbella, Fernando ^{[25
]}

Tresoldi, Simone ^{[26
]}

de Cesare, Nicoletta ^{[27
]}

Rigattieri, Stefano ^{[28
]}

Zingarelli, Antonio ^{[29
]}

Tosi, Paolo ^{[30
]}

van 't Hof, Arnoud ^{[31
]}

Boccuzzi, Giacomo

Omerovic, Elmir ^{[32
]}

Sabate, Manel ^{[33
]}

Heg, Dik ^{[4
]}

Vranckx, Pascal ^{[34
]}

Valgimigli, Marco ^{[35
]}

机构：

[1] Hosp Univ & Politecn La Fe, Cardiol Dept, Valencia, Spain

[2] Ctr Invest Biomed Red CIBERCV, Madrid, Spain

[3] MedStar Washington Hosp Ctr, Intervent Cardiol, 10 Irving St NW, Washington, DC 20010 USA

[4] Univ Bern, CTU Bern, Bern, Switzerland

[5] Univ Pavia, Dept Mol Med, Coronary Care Unit, Pavia, Italy

[6] Fdn IRCCS Policlin San Matteo, Pavia, Italy

[7] Maria Vittoria Hosp, Dept Invas Cardiol, Turin, Italy

[8] Sant Anna & San Sebastiano, Div Cardiol, Caserta, Italy

[9] Univ Campania Luigi Vanvitelli, Dept Translat Med, Caserta, Italy

[10] AO Osped Civile Vimercate, Cardiol Dept, Vimercate, Italy

[11] ASL3 Osped Villa Scassi, Dept Cardiol, Genoa, Italy

[12] Clin Mediterranea, Cardiol Dept, Naples, Italy

[13] Univ Messina, Azienda Osped Univ Policlin Gaetano Martino, Messina, Italy

[14] UO Cardiol, ASL 9 Grosseto, Grosseto, Italy

[15] Maria Pia Hsopital, GVM Care & Res, Turin, Italy

[16] AO Osped Treviglio Caravaggio, Cardiol Dept, Treviglio, Italy

[17] IRCCS San Raffaele Sci Inst, Intervent Cardiol Unit, Milan, Italy

[18] ASL VCO, Div Cardiol, Verbania, Italy

[19] Osped FatebeneFratelli, Cardiol Dept, Milan, Italy

[20] Casa Cura Villa Verde, Cardiol Dept, Taranto, Italy

[21] Osped Sirai, Cardiol Dept, Carbonia, Italy

[22] Federico II Univ Naples, Dept Adv Biomed Sci, Div Cardiol, Naples, Italy

[23] Infermi Hosp, Cardiovasc Dept, Rimini, Italy

[24] Sapienza Univ Rome, Policlin Umberto1, Rome, Italy

[25] Osped Riuniti Rivoli, Cardiol Unit, ASL Torino 3, Turin, Italy

[26] Azienda Osped Osped Desio, Cardiol Dept, Desio, Italy

[27] Policlin San Marco, Cardiol Dept, Zingonia, Italy

[28] Sandro Pertini Hosp Rome, Intervent Cardiol Unit, Rome, Italy

[29] IRCCS Azienda Osped Univ San Martino, Cardiol Dept, San Martino Buon Albergo, Italy

[30] Mater Salutis Hosp, Cardiol Dept, Legnago, Italy

[31] Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Maastricht, Netherlands

[32] Ahlgrenska Univ Hosp, Cardiol Dept, Gothenburg, Sweden

[33] Ahlgrenska Univ Hosp, Cardiol Dept, Gothenburg, Sweden

[34] Jessa Ziekenhuis, Dept Cardiol & Crit Care Med, Hartcentrum Hasselt, Hasselt, Belgium

[35] Ente Osped Cantonale, Cardioctr Ticino Inst, Div Cardiol, Via Tesserete 48, CH-6900 Lugano, Switzerland

来源：

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE | 2023年 / 12卷 / 11期

关键词：

Acute coronary syndromes; Coronary calcification; Percutaneous coronary intervention; Coronary artery bypass grafting; Medical therapy; ACUTE MYOCARDIAL-INFARCTION; ELUTING STENT IMPLANTATION; LONG-TERM OUTCOMES; ACUTE CATHETERIZATION; HARMONIZING OUTCOMES; RISK STRATIFICATION; CALCIFIED VESSELS; ARTERY-DISEASE; INTERVENTION; IMPACT;

D O I：

10.1093/ehjacc/zuad122

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims The role of coronary calcification on clinical outcomes among different revascularization strategies in patients presenting with acute coronary syndromes (ACSs) has been rarely investigated. The aim of this investigation is to evaluate the role of coronary calcification, detected by coronary angiography, in the whole spectrum of patients presenting with acute ACS.Methods and results The present study was a post hoc analysis of the MATRIX programme. The primary endpoint was major adverse cardiovascular events (MACE), defined as the composite of all-cause mortality, myocardial infarction (MI), or stroke up to 365 days. Among the 8404 patients randomized in the MATRIX trial, data about coronary calcification were available in 7446 (88.6%) and therefore were included in this post hoc analysis. Overall, 875 patients (11.7%) presented with severe coronary calcification, while 6571 patients (88.3%) did not present severe coronary calcification on coronary angiography. Fewer patients with severe coronary calcification underwent percutaneous coronary intervention whereas coronary artery bypass grafting or medical therapy-only was more frequent compared with patients without severe calcification. At 1-year follow-up, MACE occurred in 237 (27.1%) patients with severe calcified coronary lesions and 985 (15%) patients without severe coronary calcified lesions [hazard ratio (HR) 1.91; 95% confidence interval (CI) 1.66-2.20, P < 0.001]. All-cause mortality was 8.6% in patients presenting with and 3.7% in those without severe coronary calcification (HR 2.38, 1.84-3.09, P < 0.001). Patients with severe coronary calcification incurred higher rate of MI (20.1% vs. 11.5%, HR 1.81; 95% CI 1.53-2.1, P < 0.001) and similar rate of stroke (0.8% vs. 0.6%, HR 1.35; 95% CI 0.61-3.02, P = 0.46).Conclusion Patients with ACS and severe coronary calcification, as compared to those without, are associated with worse clinical outcomes irrespective of the management strategy.

引用

页码：782 / 791

页数：10

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