{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:35:36Z","timestamp":1790948136778,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,6,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Percutaneous coronary intervention of calcified lesions was associated with worse outcomes in the era of bare\u2010metal and first\u2010generation drug\u2010eluting stents. Data on percutaneous coronary intervention of calcified lesions with newer\u2010generation drug\u2010eluting stents are scarce. Therefore, we investigated the impact of lesion calcification on clinical outcomes in patients undergoing percutaneous coronary intervention with a bioresorbable\u2010polymer sirolimus\u2010eluting stent or a durable\u2010polymer everolimus\u2010eluting stent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients (n=2361) from BIOFLOW II, IV, and V trials were categorized into moderate\/severe versus none\/mild lesion calcification by a core laboratory. End points were target\u2010lesion failure (TLF) (cardiac death, target\u2010vessel myocardial infarction, or target\u2010lesion revascularization) and probable\/definite stent thrombosis at 2\u00a0years. The agreement in calcification assessment between the operator and the core laboratory was weak (weighted \u03ba, 0.23). Patients with moderate\/severe calcification (n=303; 16%) had higher TLF (13.5% versus 8.4%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.003) and stent thrombosis rates (2.1% versus 0.2%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001), whereas target\u2010lesion revascularization was not different between the groups (5.0% versus 3.9%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.302). After adjustment, calcification did not emerge as an independent predictor of TLF (adjusted hazard ratio [aHR], 1.37; 95% CI, 0.89\u20132.08;\n                      <jats:italic>P<\/jats:italic>\n                      =0.148) but did for target\u2010vessel myocardial infarction (aHR, 1.66; 95% CI, 1.03\u20132.68;\n                      <jats:italic>P<\/jats:italic>\n                      =0.037). TLF rates were similar between bioresorbable\u2010polymer sirolimus\u2010eluting stent and durable\u2010polymer everolimus\u2010eluting stent (12.6% versus 15.4%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.482) in moderate\/severe calcification. In none\/mild calcification, the bioresorbable\u2010polymer sirolimus\u2010eluting stent showed lower TLF (7.5% versus 10.3%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.045).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">With newer\u2010generation drug\u2010eluting stents, moderate\/severe lesion calcification was not associated with more TLF after adjustment for the higher risk of patients with coronary calcification, whereas the rate of target\u2010vessel myocardial infarction was higher. The bioresorbable\u2010polymer sirolimus\u2010eluting stent and durable\u2010polymer everolimus\u2010eluting stent were equally effective and safe in calcified lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifiers: NCT01356888, NCT01939249, NCT02389946.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.019815","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T05:28:23Z","timestamp":1622266103000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Impact of Coronary Calcification on Clinical Outcomes After Implantation of Newer\u2010Generation Drug\u2010Eluting Stents"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5390-0916","authenticated-orcid":false,"given":"Rayyan","family":"Hemetsberger","sequence":"first","affiliation":[{"name":"Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Abdelghani","sequence":"additional","affiliation":[{"name":"Cardiology Department Al\u2010Azhar University Cairo Egypt"},{"name":"Cardiology Department Amsterdam University Medical CenterUniversity of Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Toelg","sequence":"additional","affiliation":[{"name":"Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-5371","authenticated-orcid":false,"given":"Nader","family":"Mankerious","sequence":"additional","affiliation":[{"name":"Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-6789","authenticated-orcid":false,"given":"Abdelhakim","family":"Allali","sequence":"additional","affiliation":[{"name":"Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector M.","family":"Garcia\u2010Garcia","sequence":"additional","affiliation":[{"name":"Medstar Washington Hospital Center 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