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Int J Cardiol. 2016 Dec 1;224:50-56. doi: 10.1016/j.ijcard.2016.08.317. Epub 2016 Aug 23.

Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention.

Author information

1
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, United States.
2
Columbia University, New York, NY, United States.
3
Henry Ford Hospital, Detroit, MI, United States.
4
Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
5
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
6
VA San Diego Healthcare System and University of California San Diego, La Jolla, CA, United States.
7
University of Washington, Seattle, WA, United States.
8
Torrance Memorial Medical Center, Torrance, CA, United States.
9
St. Luke's Mid America Heart Institute, Kansas City, MO, United States.
10
Piedmont Heart Institute, Atlanta, GA, United States.
11
Medical Center of the Rockies, Loveland, CO, United States.
12
University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
13
Minneapolis VA Health Care System and University of Minnesota, Minneapolis, MN, United States.
14
Boston Scientific, Natick, MA, United States.
15
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, United States. Electronic address: esbrilakis@gmail.com.

Abstract

BACKGROUND:

Various scoring systems have been developed to predict the technical outcome and procedural efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

METHODS:

We examined the predictive capacity of 3 CTO PCI scores (Clinical and Lesion-related [CL], Multicenter CTO registry in Japan [J-CTO] and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention [PROGRESS CTO] scores) in 664 CTO PCIs performed between 2012 and 2016 at 13 US centers.

RESULTS:

Technical success was 88% and the retrograde approach was utilized in 41%. Mean CL, J-CTO and PROGRESS CTO scores were 3.9±1.9, 2.6±1.2 and 1.4±1.0, respectively. All scores were inversely associated with technical success (p<0.001 for all) and had moderate discriminatory capacity (area under the curve 0.691 for the CL score, 0.682 for the J-CTO score and 0.647 for the PROGRESS CTO score [p=non-significant for pairwise comparisons]). The difference in technical success between the minimum and maximum CL score strata was the highest (32%, vs. 15% for J-CTO and 18% for PROGRESS CTO scores). All scores tended to perform better in antegrade-only procedures and correlated significantly with procedure time and fluoroscopy dose; the CL score also correlated significantly with contrast utilization.

CONCLUSIONS:

CL, J-CTO and PROGRESS CTO scores perform moderately in predicting technical outcome of CTO PCI, with better performance for antegrade-only procedures. All scores correlate with procedure time and fluoroscopy dose, and the CL score also correlates with contrast utilization.

KEYWORDS:

Chronic total occlusion; Complications; Outcomes; Percutaneous coronary intervention; Procedural success; Techniques

PMID:
27611917
DOI:
10.1016/j.ijcard.2016.08.317
[Indexed for MEDLINE]

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