Evidence map›Paper›PMID 42589651›Full record

ReviewInternational journal of molecular sciences2026

Coronary Calcified Nodules: From Pathological Definitions to Intravascular Imaging- and Morphology-Guided PCI.

Mateusz Lucki, Sylwia Iwańczyk, Ewa Lucka, Marek Grygier, Przemysław Mitkowski, Maciej Lesiak

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mateusz LuckiDepartment and Clinic of Cardiology, University of Medical Sciences, 60-545 Poznań, Poland.ORCID 0000-0002-6788-6067
Sylwia IwańczykDepartment and Clinic of Cardiology, University of Medical Sciences, 60-545 Poznań, Poland.ORCID 0000-0003-0509-6075
Ewa LuckaClinical Rehabilitation Laboratory, Department of Rehabilitation and Physiotherapy, University of Medical Sciences, 60-545 Poznań, Poland.ORCID 0000-0002-8248-2247
Marek GrygierDepartment and Clinic of Cardiology, University of Medical Sciences, 60-545 Poznań, Poland.ORCID 0000-0002-1134-7099
Przemysław MitkowskiDepartment and Clinic of Cardiology, University of Medical Sciences, 60-545 Poznań, Poland.ORCID 0000-0001-9309-674X
Maciej LesiakDepartment and Clinic of Cardiology, University of Medical Sciences, 60-545 Poznań, Poland.ORCID 0000-0003-2630-5016

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronary artery calcification (CAC) is a hallmark of advanced atherosclerosis and a major determinant of procedural complexity during percutaneous coronary intervention (PCI). Once considered a passive consequence of vascular degeneration, CAC is now recognized as an active, highly regulated process driven by inflammation, oxidative stress, extracellular vesicle release, osteogenic differentiation of vascular smooth muscle cells, and biomechanical remodeling. These mechanisms generate a spectrum of calcific phenotypes, ranging from microcalcifications and sheet calcium to nodular calcium and calcified nodules. Calcified nodules represent an advanced fibrocalcific plaque phenotype characterized by fractured calcific plates, luminal calcium protrusion, surface disruption, and variable thrombus formation. They can be characterized using intravascular ultrasound (IVUS), optical coherence tomography (OCT), and hybrid near-infrared spectroscopy-IVUS imaging, and are associated with coronary thrombosis, stent underexpansion, restenosis, target lesion failure, and the need for advanced calcium-modification strategies. A structured literature search of PubMed/MEDLINE, Web of Science Core Collection, and Scopus identified 83 publications published between 2020 and 2026 for inclusion in the narrative synthesis. This narrative review summarizes the biological and biomechaniclam mechanisms of coronary calcification and calcified nodule formation, compares multimodality intravascular imaging criteria, and discusses contemporary imaging-guided PCI strategies, including balloon-based modification, rotational and orbital atherectomy, excimer laser coronary atherectomy, intravascular lithotripsy, and hybrid approaches. By integrating pathobiology, intravascular imaging criteria, and lesion-specific PCI strategies, this review provides a clinically oriented framework for the assessment and management of calcified nodules. Future directions include standardized imaging definitions, prospectively validated morphology-guided treatment algorithms, and computational and artificial intelligence-assisted plaque characterization.

Indexed as

Coronary Artery DiseasePercutaneous Coronary InterventionVascular CalcificationCoronary VesselsHumansTomography, Optical CoherenceUltrasonography, Interventionalcalcified nodulescoronary artery calcificationcoronary artery diseaseintravascular imagingintravascular ultrasoundnodular calciumoptical coherence tomographypercutaneous coronary intervention

Identifiers

PMID42589651
PMCPMC13466782

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.