Management of Coronary Calcified Nodules: A Position Statement

@article{yangcao2026management,
  title = {{Management of Coronary Calcified Nodules: A Position Statement}},
  author = {Yang Cao, MD and Dingyu Wang, MD and Achmad Fauzi Yahya, MD and Mehmet Ali Oto, MD, PhD and Chiung-Jen Wu, MD and Yue Wu, MD and Xiang Cheng, MD and Yong Zeng, MD and Yongtai Gong, MD and Shoichi Kuramitsu, MD, PhD and Yoshifumi Kashima, MD and Jinwei Tian, MD and Zhiren Zhang, MD, PhD and Haibo Jia, MD and Shengxian Tu, MD and Lei Song, MD and Wenqi Zhang, MD and Xiao Wang, MD and Chenguang Li, MD and Chee Yang Chin, MD, MSc and Tetsumin Lee, MD, PhD and Mitsuaki Matsumura, BS and Danghui Sun, MD and Tiankai Li, MD and Mingyou Zhang, MD and Ahmed Kassem, MD and Guo Dong, MD and Jianqiang Li, MD and Bo Luan, MD and Ho Lam, MBChB and Fei Ye, MD and Md Misbahul Ferdous, PhD and Nanhu Quan, MD and Ran Zhang, MD and Jingang Zheng, MD and Yong He, MD and Dong Yin, MD and Vijayakumar Subban, MD and Jing Li, MD and Yongle Li, MD and Yunpeng Shang, MD and Kok Han Chee, MBBS, MMed and Zaixin Yu, MD and Ye Zhu, MD and Hui Li, MD and Pengwei Song, BM and Yida Tang, MD and Changhong Lu, MD and Jamal Dabbas, MD and Firdavs Shukurov, MD, PhD and Evgeny I. Kretov, MD, PhD and Gary S. Mintz, MD and Kai-Hang Yiu, MD, PhD and Kefei Dou, MD and Yue Li, MD},
  journal = {JACC: Asia},
  year = {2026},
  month = nov,
  doi = {10.1016/j.jacasi.2026.08.029},
  url = {https://doi.org/10.1016/j.jacasi.2026.08.029},
  note = {CC BY},
}

TY  - JOUR
TI  - Management of Coronary Calcified Nodules: A Position Statement
AU  - Yang Cao, MD
AU  - Dingyu Wang, MD
AU  - Achmad Fauzi Yahya, MD
AU  - Mehmet Ali Oto, MD, PhD
AU  - Chiung-Jen Wu, MD
AU  - Yue Wu, MD
AU  - Xiang Cheng, MD
AU  - Yong Zeng, MD
AU  - Yongtai Gong, MD
AU  - Shoichi Kuramitsu, MD, PhD
AU  - Yoshifumi Kashima, MD
AU  - Jinwei Tian, MD
AU  - Zhiren Zhang, MD, PhD
AU  - Haibo Jia, MD
AU  - Shengxian Tu, MD
AU  - Lei Song, MD
AU  - Wenqi Zhang, MD
AU  - Xiao Wang, MD
AU  - Chenguang Li, MD
AU  - Chee Yang Chin, MD, MSc
AU  - Tetsumin Lee, MD, PhD
AU  - Mitsuaki Matsumura, BS
AU  - Danghui Sun, MD
AU  - Tiankai Li, MD
AU  - Mingyou Zhang, MD
AU  - Ahmed Kassem, MD
AU  - Guo Dong, MD
AU  - Jianqiang Li, MD
AU  - Bo Luan, MD
AU  - Ho Lam, MBChB
AU  - Fei Ye, MD
AU  - Md Misbahul Ferdous, PhD
AU  - Nanhu Quan, MD
AU  - Ran Zhang, MD
AU  - Jingang Zheng, MD
AU  - Yong He, MD
AU  - Dong Yin, MD
AU  - Vijayakumar Subban, MD
AU  - Jing Li, MD
AU  - Yongle Li, MD
AU  - Yunpeng Shang, MD
AU  - Kok Han Chee, MBBS, MMed
AU  - Zaixin Yu, MD
AU  - Ye Zhu, MD
AU  - Hui Li, MD
AU  - Pengwei Song, BM
AU  - Yida Tang, MD
AU  - Changhong Lu, MD
AU  - Jamal Dabbas, MD
AU  - Firdavs Shukurov, MD, PhD
AU  - Evgeny I. Kretov, MD, PhD
AU  - Gary S. Mintz, MD
AU  - Kai-Hang Yiu, MD, PhD
AU  - Kefei Dou, MD
AU  - Yue Li, MD
PY  - 2026
DA  - 2026/11/05
JO  - JACC: Asia
DO  - 10.1016/j.jacasi.2026.08.029
UR  - https://doi.org/10.1016/j.jacasi.2026.08.029
AB  - Coronary calcified nodules are an uncommon but important substrate for acute coronary syndromes, stent underexpansion, and recurrent target lesion revascularization. This consensus integrates pathologic, imaging, prognostic, and interventional evidence to guide practical decision-making. Intravascular imaging is essential for diagnosis, mechanism definition, and procedural optimization. Optical coherence tomography provides superior assessment of cap disruption and thrombus, whereas intravascular ultrasound remains valuable when contrast exposure or lesion crossing limits optical coherence tomography. Treatment should be tailored to lesion crossability, calcium distribution, and the need for mechanical scaffolding. No calcium-modification device or drug-eluting stent vs drug-coated balloon strategy has demonstrated consistent superiority. The proposed type IIa/IIb framework is hypothesis-generating and requires prospective validation. Calcified nodule-related target lesion failure should be managed by correcting the dominant mechanical mechanism before antiproliferative therapy. These recommendations emphasize individualized, imaging-guided percutaneous coronary intervention and identify priorities for prospective comparative research.
SN  - 2772-3747
ER  -