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and objectives: This study aims to investigate if the non-invasive assessment of coronary calcium score using multislice cardiac computerized tomography (MSCT) may anticipate the need for elective rotational atherectomy (RA) during percutaneous coronary intervention. Methods: Patients were considered eligible for the study after receiving a diagnosis of severe coronary stenosis with moderate or severely calcified plaques during index coronary angiography. Those patients underwent the Agatston coronary artery calcium (CAC) score quantification using the MSCT and then underwent percutaneous intervention. Only those lesions considered noncrossable or non-dilatable according to a pre-specified revascularization protocol were treated with RA. All operators were blinded to the MSCT results. According to the study protocol, clinical, angiographic and Agatston-related variables were included in the statistical analysis. Short and long-term outcomes were investigated in both treatment groups during follow-up. Palabras clave: Aterectomía rotacional. Tomografía computarizada cardiaca. Agatston. Índice de calcificación coronaria. Lesiones coronarias calcificadas. Coronary artery calcium score with cardiac computed tomography to anticipate the need for rotational atherectomy 168 G. Galeote et al. REC Interv Cardiol. 2019;1(3):167-174 Abreviaturas AR: aterectomía rotacional. CC: calcificación coronaria. ICP: intervención coronaria percutánea. TCMD: tomografía computarizada cardiaca multidetector. Results: A total of 40 patients were included in the analysis: 20 underwent RA and 20 conventional percutaneous coronary interventions. Most patients were included after suffering from an acute coronary syndrome and had complex coronary anatomy (mean Syntax score, 25 points). The logistic regression analysis showed that creatinine levels and the per-lesion Agatston score were the only predictors of RA. No significant differences were observed regarding in-hospital or long-term procedural outcomes. A novel parameter, the CAC-Cre index, was found to be useful to anticipate the need for RA. Conclusions: Coronary artery calcification analysis using the Agatston score is a simple technique that improves the non-invasive assessment of complex coronary plaques prior to percutaneous coronary intervention. The per-lesion Agatston score, serum creatinine levels, and the CAC-Cre index may become useful parameters to anticipate the need for elective RAs during percutaneous coronary intervention.

�ndice de calcificaci�n coronaria en la tomograf�a computarizada para predecir la necesidad de aterectom�a rotacional