Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention. (1st December 2016)

• Record Type: Journal Article
• Authors: Karatasakis, Aris; Danek, Barbara A.; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Jaffer, Farouc A.; Yeh, Robert W.; Patel, Mitul; Bahadorani, John N.; Lombardi, William L.; Wyman, R. Michael; Grantham, J. Aaron; Kandzari, David E.; Lembo, Nicholas J.; Doing, Anthony H.; Toma, Catalin; Moses, Jeffrey W.; Kirtane, Ajay J.; Parikh, Manish A.; Ali, Ziad A.; Garcia, Santiago; Kalsaria, Pratik; Karacsonyi, Judit; Alame, Aya J.; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.
• Is Part Of: International journal of cardiology. Volume 224(2016)
• Page Start: 50
• Page End: 56
• Publication Date: 2016-12-01
• Subjects: Chronic total occlusion -- Percutaneous coronary intervention -- Procedural success -- Complications -- Techniques -- Outcomes; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.08.317
• Languages: English
• ISSNs: 0167-5273

Abstract

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.