Relationship between coronary artery calcium score and bleeding events after percutaneous coronary intervention in chronic coronary syndrome

Heart Vessels. 2023 Jul;38(7):919-928. doi: 10.1007/s00380-023-02248-7. Epub 2023 Feb 27.


The relationship between coronary artery calcium (CAC) and bleeding events after percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is not well established. This study aimed to examine the association between CAC scores and clinical outcomes after PCI in patients with CCS. This retrospective observational study included 295 consecutive patients who underwent multidetector computer tomography and were scheduled for their first elective PCI. Patients were categorized into two groups based on the CAC scores (low: ≤ 400 or high: > 400). The bleeding risk was evaluated using the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria. The primary clinical outcome was a major bleeding event within 1 year after PCI, defined as Bleeding Academic Research Consortium (BARC) 3 or 5. The high CAC score group had a higher proportion of patients meeting the ARC-HBR criteria than the low CAC score group (52.7% vs. 31.3%, p < 0.001). Kaplan-Meier survival analysis showed that the incidence of major bleeding events was higher in the high CAC score group as compared to the low CAC score group (p < 0.001). Furthermore, multivariate Cox regression anal ysis revealed that a high CAC score was an independent determinant of major bleeding events during the first year after PCI. A high CAC score is significantly associated with the incidence of major bleeding events after PCI in CCS patients.

Keywords: Bleeding events; Chronic coronary syndrome; Coronary artery calcification; Percutaneous coronary intervention; Thrombotic event.

Publication types

  • Observational Study

MeSH terms

  • Calcium
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / diagnostic imaging
  • Hemorrhage / chemically induced
  • Hemorrhage / etiology
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Platelet Aggregation Inhibitors / adverse effects
  • Risk Factors
  • Syndrome
  • Treatment Outcome


  • Calcium
  • Platelet Aggregation Inhibitors