Clinical And Imaging Features Of Coronary Artery Calcification Based On Coronary Angiography And Intravascular Ultrasound

Objective: This study aims to analyze the clinical and imaging characteristics of coronary artery calcification through collecting general information,coronary angiography and intravascular ultrasound image of patients with CAC.Thus,we investigate the clinical and imaging characteristics of coronary artery calcification,deduce the risk factors of coronary artery calcification,and improve the clinical and imaging understanding of coronary artery calcification.Methods: From January 2016 to December 2018,261 patients with stable angina pectoris or unstable angina pectoris diagnosed in the Department of Cardiovascular Medicine of the First Hospital of Jilin University were selected consecutively.6 patients were excluded,and the 255 patients included were divided into non-calcified patients,patients with low Calc Index(Calc Index=0.01-0.1399),patients with medium Calc Index(Calc Index=0.14-0.3759)and patients with high Calc Index(Calc Index?0.376)according to different calcification severity recognized by IVUS.Eventually analyze patient's baseline clinical data and laboratory tests on admission,coronary angiography and intravascular ultrasound imaging parameters using hospital's medical record system,Siemens QCA System and QIvus i Map Basic Viewer 3.0.Results:(1)There was no statistically significant difference in age,gender,BMI,hyperlipidemia,chronic renal insufficiency,smoking history,history of aspirin use,or statin use among the groups with different Calc Index(p > 0.05).The prevalence of diabetes in the four groups from non-calcification to high calcification index was 26%,26%,33% and 61%,respectively.And the difference was statistically significant(p < 0.05).In addition,there was a statistically significant difference in the prevalence of hypertension between the four groups(p < 0.05).(2)There were statistically significant differences between patients with different calcification indexes among white blood cells,platelet serum potassium and serum creatinine(p < 0.05),among which the serum creatinine showed a trend of increasing with the increase of calcification severity.The differences of serum calcium,triglyceride and LDL-c between the four groups were not statistically significant(p > 0.05).(3)There was no significant difference in the distribution of the lesions in the 0-low calcification index group and the medium-to-high Calc Index group(p > 0.05),and the lesions were mainly LAD lesions.In terms of calcification type composition,the difference between the two groups was statistically significant(p < 0.01).The 0-low calcification index group was dominated by superficial calcification,accounting for 53% of all lesions,while the medium-high calcification group was dominated by mixed calcification,accounting for 60% of all lesions.(4)There was no statistically significant difference between the 0-low Calc Index group and the medium-high Calc Index group in EEM CSA,luminal CSA,plaque load,lesion length at both reference lumen and minimum lumen(p > 0.05).The differences in calcification length and maximum calcification angle between the two groups were statistically significant(p < 0.01).The lesions in the medium-to-high Calc Index group had significantly longer calcification length and larger calcification angulation.(5)Among all the lesions included in the study,there were 103 cases of calcified lesions detected by coronary angiography.In terms of the Calc Index of the lesions,64% of calcified lesions in the medium-high Calc Index group were detected by coronary angiography,which was significantly higher than that in the 0-low Calc Index group(p < 0.01).Coronary angiography detected 68% calcified lesions of the calcified angle > 90° group,which was significantly greater than ?90° group(p < 0.01).In the group which the total lesion is longer than 10 mm,57% of calcification lesions were detected,which was significantly higher than that in the ?10mm group(p < 0.01).(6)Logistic regression analysis was carried out with the medium-high Calc Index as the dependent variable,and the results showed that hypertension,diabetes,chronic renal insufficiency,blood creatinine and white blood cells were the independent risk factors for the occurrence of medium-high Calc Index.Hypertension,diabetes,chronic renal insufficiency,serum creatinine,and leukocyte were all of medium-high Calc Index.Conclusion:(1)From perspective of clinical,the overall incidence of CAC lesions is relatively high,and there is no difference between gender,age,BMI and other data of coronary artery lesions with or without calcification.Hypertension,diabetes,chronic renal insufficiency,blood creatinine and white blood cells are independent risk factors for the occurrence of moderate to severe CAC.(2)From the perspective of imaging,CAC lesions are mostly seen in the LAD,and superficial calcification in mild calcification lesions is the majority.The severity of calcification has no significant relationship with the degree of coronary artery stenosis.(3)CAG can effectively identify severe CAC lesions,but its clinical significance and the significance of guiding interventional therapy are still very limited.