Study On Predictive Factors Of Rotational Atherectomy (RA) For Coronary Calcified Lesions

Background According to WHO’s Global Burden of Disease report in 2008,cardiovascular disease has jumped to the first place,becoming the main cause of human death.Relevant statistics show that the number of deaths caused by coronary heart disease worldwide has reached more than 7 million.With the increase of age,the incidence of vascular calcification will continue to increase.In many groups of patients with coronary heart disease,most of them have coronary artery calcification lesions.There are many studies on the mechanism of this lesion.Some studies have found that there is a close relationship between the degree of coronary artery calcification and the incidence of myocardial infarction.This kind of calcification can affect coronary artery compliance and reduce the level of myocardial perfusion,so it is necessary to treat it.Coronary artery calcification also leads to a significant increase in the risk of vascular perforation,which affects the effect of surgery and stent expansion.In the case of balloon dilatation,it is also prone to "dog bones" and other expansion problems,which can reduce the effect and increase the risk of stent thrombosis.Intravascular ultrasonography(IVUS)is the most commonly used standard for invasive examination of this disease.However,the cost of IVUS is too high to meet the examination requirements in the case of patients with severe stenosis.Therefore,coronary angiography is also a highly applied examination method in this field.Rotational Atherectomy(RA)is an effective way for the treatment of coronary calcified lesions.Currently,there is no unified standards of coronary angiography(CAG)to guide Rotational Atherectomy(RA).This study aims to quantitative assessment of calcified lesions through Quantitative Coronary Angiography(QCA).To explore the factors related to the pretreatment of coronary calcified lesions by Rotational Atherectomy(RA).Methods A retrospective collection of 103 patients with 2-4 level calcified lesions and interventional therapy in our hospital from January 2017 to August 2018 was performed.According to different treatment methods,the patients were divided into conventional treatment group and passive atherectomy group.By using the QCA method(Siemens Imaging Analysis System),the correlative imaging indexes of coronary calcified lesions were compared between the two groups.Results The lesions in the atherectomy group were statistically different from the conventionally treated lesions in stenosis diameter,stenosis degree,calcification thickness and intimal calcification.P values were less than 0.05.Inclusion of the differential treatment into the logistic regression model showed that the degree of stenosis and intimal calcification were risk factors for atherectomy in coronary calcified lesions,the P values were 0.001 and 0.027,respectively.OR values were 1.11(95%Cl 1.04-1.18)and 0.25(95%CI 0.07-0.85).ROC curve analysis of the stenosis index indicated that the area under ROC curve was 0.76(95%CI 0.66-0.81).Conclusion QCA has predictive and guiding value in the decision-making of whether coronary artery calcification should be performed Rotational Atherectomy(RA).The stenosis degree of coronary calcified lesions and intimal calcification are important risk factors for Rotational Atherectomy(RA).