Clinical Outcomes in Non-ST Elevation Myocardial Infarction Patients with High Coronary Calcium Burden

Background: Coronary artery calcification significantly impacts stent expansion and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). However, data on its effects in non-ST elevation myocardial infarction (NSTEMI) patients remain limited. Objective: This study aimed to evaluate the impact of coronary calcium burden on stent expansion and procedural outcomes in NSTEMI patients undergoing intravascular ultrasound (IVUS)-guided PCI. Methods: This cross-sectional observational study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, from May 2019 to April 2020. A total of 109 NSTEMI patients with calcified lesions were enrolled and divided into two groups: Group I (calcium arc 0–180°; n = 73) and Group II (calcium arc 181–270°; n = 36). IVUS parameters, including calcium arc, length, and stent expansion metrics, were analyzed. Data were processed using SPSS version 23.0. Results: In this study, 109 NSTEMI patients with calcified coronary lesions were analyzed. Group II (calcium arc 181–270°) had significantly higher IVUS parameters, including calcium arc, length, and reference diameters (p < 0.05). Greater calcium burden was associated with poorer stent expansion and higher post-PCI stenosis. Stent expansion showed a moderate negative correlation with calcium arc (p < 0.001). Conclusion: Higher coronary calcium burden (181–270°) is associated with poorer stent expansion and greater post-PCI stenosis in NSTEMI patients. IVUS-guided PCI and tailored strategies for calcified lesions are essential to optimize outcomes in this high-risk population.