Comparison of CT-RECTOR and J-CTO scores to predict chronic total occlusion difficulty for percutaneous coronary intervention
| Autor: | Yahang Tan, Feng Cao, Yundai Chen, Lian Chen, Jia Zhou, Feng Tian, Wei Zhang, Luo-Shan Du, Jun Guo, Ying Zhou |
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| Rok vydání: | 2017 |
| Předmět: |
Male
China medicine.medical_specialty Time Factors Scoring system Computed Tomography Angiography medicine.medical_treatment 030204 cardiovascular system & hematology Coronary Angiography Severity of Illness Index Total occlusion 030218 nuclear medicine & medical imaging 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Predictive Value of Tests Preoperative Care Humans Medicine Intraoperative Complications Aged Receiver operating characteristic business.industry Area under the curve Coronary computed tomography angiography Percutaneous coronary intervention Middle Aged Predictive value Surgery Net reclassification improvement Treatment Outcome Coronary Occlusion Research Design Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 235:169-175 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2017.02.008 |
| Popis: | Background We sought to evaluate the ability of the CT-RECTOR and J-CTO scores to predict time-efficient guidewire (GW) crossing through a chronic total occlusion (CTO) and final procedure success. Methods Data from 191 consecutive CTO lesions with pre-procedural coronary computed tomography angiography (CCTA) from our center were analyzed retrospectively. The difficulty of the procedure was classified as easy, intermediate, difficult, or very difficult according to CT-RECTOR and J-CTO scores. A successful GW crossing within 30min was set as the first endpoint. Final success of the procedure was set as the second endpoint. Receiver operating characteristic curves and net reclassification improvement (NRI) were used to compare the performance of both scores in predicting both endpoints. Results The first and second endpoints were achieved in 55% and 76% of lesions, respectively. The NRI for prediction for both endpoints were 30.21% and 28.94%, respectively. Use of the CT-RECTOR score demonstrated a positive NRI for both the first ( p =0.0027) and second ( p =0.0190) endpoints. Compared with the J-CTO score (area under the curve: 0.76), the CT-RECTOR score (area under the curve: 0.85) yielded a higher predictive value for successful GW crossing within 30min ( p =0.0018). Conclusions Compared with J-CTO, the CT-RECTOR scoring system provides a more accurate noninvasive tool for predicting time-efficient GW crossing and final procedure success. This scoring system, which is based on CCTA, may aid in the identification of very difficult CTO lesions and downstream management. |
| Databáze: | OpenAIRE |
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