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The presence of severe calcifications complicates lesion preparation, advancement of stents and achievement of full stent expansion. Intervention in these lesions is associated with an increased risk of complications and procedural failure compared with treatment of less calcified lesions. Due to the high burden of comorbidity, patients with severely calcified lesions are often excluded from interventional trials, and there is little evidence on how to treat these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a systematic review of randomised trials enrolling patients with calcified coronary artery disease undergoing percutaneous coronary intervention. We will investigate any percutaneous treatment option including any lesion preparation, stenting or postdilatation technique. We will search The Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Health Sciences Literature, Science Citation Index Expanded, and Excerpta Medica database for studies from inception to 31 October 2022. The coprimary outcome is all-cause mortality and serious adverse events. If appropriate, we will conduct meta-analysis, trial sequential analysis and network meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>No ethics approval is required for this study. The results will be published in a peer-reviewed journal in this field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42021226034.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-063884","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T11:06:32Z","timestamp":1662116792000},"page":"e063884","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Percutaneous coronary intervention in calcified stenoses: a protocol for a systematic review with meta-analysis, trial sequential analysis and network meta-analysis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4570-236X","authenticated-orcid":false,"given":"Andreas","family":"Torp Kristensen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janus C","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Copenhagen Trial Unit, Centre for Clinical Interventional Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels Thue","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"2025121523544852000_12.9.e063884.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)31012-1"},{"key":"2025121523544852000_12.9.e063884.2","unstructured":"ESC prevention of CVD programme: epidemiology of IHD. 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