{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:33:25Z","timestamp":1791228805973,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>There is limited information on the clinical relevance and procedural impact of coronary artery calcification (CAC) in the contemporary percutaneous coronary intervention (PCI) setting. This study sought to determine the incidence and clinical significance of procedural techniques on the outcomes in \u2018real-world\u2019 patients with CAC undergoing PCI with drug-eluting stents (DESs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Using patient-level data from seven stent-specific, prospective DES registries, we evaluated 17\u2009084 patients who underwent PCI with various DES types between July 2007 and July 2015. The primary outcome was target-vessel failure (TVF), defined as a composite of cardiac death, target-vessel myocardial infarction, or target-vessel revascularization. Outcomes through 3\u2009years (and between 0\u20131 and 1\u20133\u2009years) were assessed according to CAC status (none\/mild vs. moderate\/severe) and stenting technique (predilation or post-dilation). Among 17\u2009084 patients with 22\u2009739 lesions included in the pooled dataset, moderate to severe CAC was observed in 11.3% of patients (10.1% of lesions). Older age, lower BMI, diabetes, hypertension, family history of coronary artery disease, and renal failure were independent predictors of moderate\/severe CAC. The presence of moderate\/severe CAC was significantly associated with an adjusted risk of TVF at 3\u2009years [hazard ratio, 1.37; 95% confidence interval (CI), 1.19\u20131.58;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001]. For severe CAC, optimal lesion preparation with predilation was associated with a lower 3-year rate of TVF (no vs. yes, 22.3 vs. 12.8%), in which the effect of predilation was prominent at the late period of 1\u20133\u2009years (hazard ratio, 0.28; 95% CI, 0.12\u20130.69;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.003) than at the early period through 1\u2009year (hazard ratio, 1.16; 95% CI, 0.37\u20133.71;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.80). However, post-dilation (with a high-pressure noncompliant balloon) had no effect on the outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study, moderate\/severe CAC was common (~10%) and strongly associated with TVF during 3\u2009years of follow-up. For severe CAC, optimal lesion preparation with pre-balloon dilation has a significant effect on long-term outcomes, especially during the late period beyond 1\u2009year. Clinical Trial Registration \u2013 URL: http:\/\/www.clinicaltrials.gov. Unique identifier: NCT01186133.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/mca.0000000000000896","type":"journal-article","created":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T19:58:43Z","timestamp":1587326323000},"page":"42-50","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence, predictors, prognostic significance, and effect of techniques on outcomes of coronary lesion calcification following implantation of drug-eluting stents: a patient-level pooled analysis of stent-specific, multicenter, prospective IRIS-DES registries"],"prefix":"10.1097","volume":"32","author":[{"given":"Cheol Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu Sup","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do-Yoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pil Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Whan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Whan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Wook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duk-Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"R1-20250729","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1016\/j.jacc.2014.01.017","article-title":"Coronary artery calcification: pathogenesis and prognostic implications.","volume":"63","author":"Madhavan","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"R2-20250729","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1016\/j.jacc.2014.01.034","article-title":"Ischemic outcomes after coronary intervention of calcified vessels in acute coronary syndromes. 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