Predicting Successful Recanalization in Patients with Native Coronary Chronic Total Occlusion: The Busan CTO Score
| Autor: | Moo Hyun Kim, Kwang Min Lee, Young Rak Cho, Tae Hyung Kim, Soo Jin Kim, Cai De Jin, Victor L. Serebruany |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Cross-sectional study medicine.medical_treatment Dentistry 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences Coronary circulation Percutaneous Coronary Intervention 0302 clinical medicine Japan Predictive Value of Tests Coronary Circulation Internal medicine Severity of illness medicine Humans Pharmacology (medical) Prospective Studies Registries 030212 general & internal medicine Prospective cohort study Aged business.industry Percutaneous coronary intervention Middle Aged Coronary Vessels Cross-Sectional Studies Logistic Models Treatment Outcome medicine.anatomical_structure Coronary Occlusion ROC Curve Coronary occlusion Predictive value of tests Multivariate Analysis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology. 137:83-91 |
| ISSN: | 1421-9751 0008-6312 |
| Popis: | Background: The optimal strategy to manage chronic total occlusion (CTO) remains unclear. The Japanese CTO multicenter registry (J-CTO) score is an established tool for predicting successful recanalization. However, it does not take into account nonangiographic predictors for final technique success. In the present study, we designed and tested a scoring model called the Busan single-center CTO registry (B-CTO) score combining clinical and angiographic characteristics to predict successful CTO recanalization in Korean patients. Methods: Prospectively enrolled CTO patients (n = 438) undergoing coronary intervention (1999-2015) were assessed. The B-CTO score comprises 6 independent predictors: age 60-74 years and lesion length ≥20 mm were assigned 1 point each, while age ≥75 years, female gender, lesion location in the right coronary artery, blunt stump, and bending >45° were assigned 2 points each. For each predictor, the points assigned were based on the associated odds ratio by multivariate analysis. The lesions were classified into 4 groups according to the summation of points scored to assess the probability of successful CTO recanalization: easy (score 0-1), intermediate (score 2-3), difficult (score 4-5), and very difficult (score ≥6). CTO opening was designated as the primary endpoint regardless of the interventional era or the skill of the operator. Results: The final success rate for B-CTO was 81.1%. The probability of successful recanalization for patient groups classified as easy (n = 64), intermediate (n = 148), difficult (n = 134), and very difficult (n = 92) was 95.3, 86.5, 79.1 and 65.2%, respectively (p for trend Conclusions: The B-CTO score has been designed and validated in Korean patients with native coronary CTO and is an improved tool for predicting successful recanalization. Wider application of the B-CTO score remains to be explored. |
| Databáze: | OpenAIRE |
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