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Impact of spotty calcification on long-term prediction of future revascularization: a prospective three-vessel intravascular ultrasound study

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Abstract

To date, there are no prospective studies on the relationship between plaque characteristics identified by 40 MHz IVUS and future adverse events. This prospective study evaluated the relationship between plaque morphology in nonculprit nonsignificant lesions, determined by 40 MHz IVUS, and long-term clinical outcomes. Consecutively, 45 patients who underwent 3-vessel intravascular ultrasound (IVUS) examinations were prospectively enrolled. Qualitative and quantitative IVUS analyses including scoring of echogenicity for assessment of plaque characterization were performed for each nonsignificant nonculprit lesion. The number, the length, the location (superficial or deep), and maximum arc were measured for each calcium deposit within plaques. Spotty calcification was defined as calcium deposits <90° and <6 mm in length. Primary end point was defined as nonsignificant nonculprit lesion-related revascularization (NNLR) during 6 years of follow-up. A total of 163 nonsignificant nonculprit lesions with mild to moderate stenosis were identified on baseline 3-vessel IVUS. Of those 163 lesions, six lesions required NNLR during the follow-up period. There were no differences in quantitative IVUS parameters including remodeling index, plaque burden, and echogenicity between lesions requiring and not requiring NNLR. However, deep spotty calcification was more frequently identified in lesions requiring NNLR than in those not requiring NNLR (33 vs. 8 %, P = 0.02). Spotty calcium deposits identified by 40 MHz IVUS predicted the need for NNLR during a 6-year follow-up period. This finding suggests that deep spotty calcium may be a surrogate marker for plaque progression and the subsequent need for revascularization in the future.

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Acknowledgments

The authors thank the staffs in the catheterization laboratory at Hyogo College of Medicine for their excellent assistance during the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Cardiovascular Division, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan

    Hiroto Tamaru, Kenichi Fujii, Masashi Fukunaga, Takahiro Imanaka, Kojiro Miki, Tetsuo Horimatsu, Machiko Nishimura, Ten Saita, Akinori Sumiyoshi, Masahiko Shibuya, Yoshiro Naito & Tohru Masuyama

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  1. Hiroto Tamaru
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  2. Kenichi Fujii
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  3. Masashi Fukunaga
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  4. Takahiro Imanaka
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  5. Kojiro Miki
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Correspondence to Kenichi Fujii.

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Tamaru, H., Fujii, K., Fukunaga, M. et al. Impact of spotty calcification on long-term prediction of future revascularization: a prospective three-vessel intravascular ultrasound study. Heart Vessels 31, 881–889 (2016). https://doi.org/10.1007/s00380-015-0687-8

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  • DOI: https://doi.org/10.1007/s00380-015-0687-8

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