Akiko Maehara
Cardiovascular Research Foundation Akiko Maehara, MD (Columbia University, Cardiovascular Research Foundation, New York, USA) started the lecture with a question,
"What kind of calcified plaque should be treated?".

The OCT study that was introduced enrolled 272 calcified nodules (CNs) in 230 patients who underwent pre- and post-optical coherence tomography (OCT). Nodules were divided into 2 groups, which were eruptive and non-eruptive CNs. In this study, the prevalence of CN was 5.9% per vessel and 7.3% per patient (Figure 1).

Explosive Calcified Nodules (CNs): Predictors of Better Stent Expansion but Worse Post-PCI Outcomes

Maehara stated that eruptive CNs are one of the predictors of better stent expansion because of the re-distribution mechanism of plaques. However, eruptive CNs showed a worse post-percutaneous coronary intervention (PCI) outcome in terms of target lesion failure (TLF) compared to non-eruptive CNs (Figure 2). Factors associated with 2-year TLF included eruptive CNs, the circumference of the CN, angle in lesions, and the stent area.

The lecture concluded with the following messages,
1) Stent implantation deformed an eruptive CN more than a noneruptive CN
2) Non-eruptive CN, greater CN, greater surrounding calcium, and negative remodeling were associated with poor stent expansion
3) TLR increased at 6 months post-PCI in the eruptive CN group more than non-eruptive CN group
4) An eruptive CN, greater CN, greater hinge motion, and small stent area were associated with a worse 2-year TLF

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