Renal Function, OCT-Defined Coronary Calcification and Stent Optimization in Optical Coherence Tomography-Guided Percutaneous Coronary Intervention: A Single-Center Cross-Sectional Study.
- 1Department of Cardiology, Kien Giang General Hospital, Rach Gia, An Giang Province, Vietnam.
- 2Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
- 3Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
Abstract
Reduced renal function is linked to coronary calcification, which can limit stent expansion, and to contrast-associated acute kidney injury (CI-AKI). We examined renal function, optical coherence tomography (OCT)-defined calcification and OCT measures of stent optimization in a Vietnamese provincial hospital. This prospective, single-center, cross-sectional study included consecutive patients undergoing OCT-guided percutaneous coronary intervention (December 2023 to January 2026). eGFR was calculated with the CKD-EPI 2021 equation and CI-AKI defined by KDIGO creatinine criteria. Lesion-level associations were estimated by logistic or linear regression with patient-clustered robust standard errors, before and after adjustment for age, sex, diabetes, hypertension, smoking and acute coronary syndrome. The cohort comprised 300 patients, 309 procedures and 356 lesions. Mean eGFR was 79.7 ± 20.7 mL/min/1.73 m2 and 60 procedures (19.4%) had eGFR <60. Calcification was present in 235 lesions (66.0%). Each 10 mL/min/1.73 m2 lower eGFR was associated with calcification in unadjusted analysis (OR 1.19; 95% CI 1.03-1.38), but not after adjustment including age (OR 1.04; 0.88-1.22), whereas age remained associated (OR 1.46 per 10 years; 1.09-1.95). Mean minimum stent area was 5.75 ± 2.26 mm2 and was not correlated with eGFR (ρ=0.05; P=0.36); stent expansion ≥80% (87.4%) and procedural success (88.7%) were not associated with eGFR in crude or adjusted models. CI-AKI occurred in 8 of 206 procedures with paired creatinine (3.9%). Subgroups with eGFR <45 (22 lesions) and <30 (7 lesions) were small, and these analyses were exploratory. In this single-center cross-sectional study, the crude association between lower eGFR and OCT-defined calcification was largely explained by age. Under OCT guidance, renal function was not associated with stent optimization, and CI-AKI was infrequent. Prospective studies with larger advanced-CKD populations and a comparator arm are needed to establish whether OCT guidance offsets renal-related procedural disadvantage.
Related
- Artificial Intelligence‐Assisted Automated Optical Coherence Tomography Analysis for Percutaneous Coronary Intervention Planning: From Plaque Analysis to Precision Lesion Preparation and Stent Optimization
- Determinants and Clinical Impact of Direct Stenting in Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction ― An ATLAS-OCT Substudy ―
- Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention: a reconstructed individual participant data meta-analysis of randomized controlled trials of intravascular ultrasound- and optical coherence tomography-guided strategies
- Residual SYNTAX score and optical coherence tomography–derived thin-cap fibroatheroma in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention: an exploratory descriptive pilot study
- Anomalous coronary origin and severe calcification: a challenge for percutaneous coronary intervention. Case report
BibTeX
@article{huynh2026renal,
title = {{Renal Function, OCT-Defined Coronary Calcification and Stent Optimization in Optical Coherence Tomography-Guided Percutaneous Coronary Intervention: A Single-Center Cross-Sectional Study.}},
author = {Cang Trung Huynh and Trung Minh Tran and Kien Trung Nguyen and Ha Hong Nguyen},
journal = {Vascular health and risk management},
year = {2026},
month = nov,
doi = {10.2147/vhrm.s647284},
url = {https://europepmc.org/article/MED/42999609},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Renal Function, OCT-Defined Coronary Calcification and Stent Optimization in Optical Coherence Tomography-Guided Percutaneous Coronary Intervention: A Single-Center Cross-Sectional Study.
AU - Cang Trung Huynh
AU - Trung Minh Tran
AU - Kien Trung Nguyen
AU - Ha Hong Nguyen
PY - 2026
DA - 2026/11/03
JO - Vascular health and risk management
DO - 10.2147/vhrm.s647284
UR - https://europepmc.org/article/MED/42999609
AB - Reduced renal function is linked to coronary calcification, which can limit stent expansion, and to contrast-associated acute kidney injury (CI-AKI). We examined renal function, optical coherence tomography (OCT)-defined calcification and OCT measures of stent optimization in a Vietnamese provincial hospital. This prospective, single-center, cross-sectional study included consecutive patients undergoing OCT-guided percutaneous coronary intervention (December 2023 to January 2026). eGFR was calculated with the CKD-EPI 2021 equation and CI-AKI defined by KDIGO creatinine criteria. Lesion-level associations were estimated by logistic or linear regression with patient-clustered robust standard errors, before and after adjustment for age, sex, diabetes, hypertension, smoking and acute coronary syndrome. The cohort comprised 300 patients, 309 procedures and 356 lesions. Mean eGFR was 79.7 ± 20.7 mL/min/1.73 m2 and 60 procedures (19.4%) had eGFR <60. Calcification was present in 235 lesions (66.0%). Each 10 mL/min/1.73 m2 lower eGFR was associated with calcification in unadjusted analysis (OR 1.19; 95% CI 1.03-1.38), but not after adjustment including age (OR 1.04; 0.88-1.22), whereas age remained associated (OR 1.46 per 10 years; 1.09-1.95). Mean minimum stent area was 5.75 ± 2.26 mm2 and was not correlated with eGFR (ρ=0.05; P=0.36); stent expansion ≥80% (87.4%) and procedural success (88.7%) were not associated with eGFR in crude or adjusted models. CI-AKI occurred in 8 of 206 procedures with paired creatinine (3.9%). Subgroups with eGFR <45 (22 lesions) and <30 (7 lesions) were small, and these analyses were exploratory. In this single-center cross-sectional study, the crude association between lower eGFR and OCT-defined calcification was largely explained by age. Under OCT guidance, renal function was not associated with stent optimization, and CI-AKI was infrequent. Prospective studies with larger advanced-CKD populations and a comparator arm are needed to establish whether OCT guidance offsets renal-related procedural disadvantage.
SN - 1176-6344
SN - 1178-2048
ER -