Impact of Coronary Artery Calcium Score on Procedural Success and Long-Term Outcomes Following Complex Percutaneous Coronary Intervention

Abstract

Objective: To assess the effect of coronary artery calcium (CAC) score on outcomes and procedural success after complex PCI.

Methods: This is a retrospective observational cohort study of 86 patients who underwent complex PCI from September 2022 to March 2023 at the Punjab Institute of Cardiology in Lahore. Patients were separated into two groups based on their CAC score: <300 and ≥300. Demographic, clinical, angiographic, and procedural data were analyzed. SPSS 26 was used for analysis. Logistic and Cox regression analyzes were used to identify independent factors.

Results: Patients with CAC ≥300 had lower procedural success than those with CAC <300 (p=0.021). Longer procedures, higher contrast, increased radiation exposure, and higher frequency of rotational atherectomy were associated with higher CAC. MACE was considerably greater in patients with CAC ≥300 (p=0.009). CAC ≥300 independently predicted procedural failure (p=0.049), complications (p=0.048), and MACE (p=0.027).

Conclusion: CAC burden was linked to worse procedural success and long-term outcomes following complicated PCI. The use of CAC scoring can enhance preprocedural risk stratification and procedural planning.

Keywords: Coronary artery calcium score; Complex percutaneous coronary intervention; Coronary artery calcification.