Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions
| Autor: | Khaldoon Alaswad, J. Aaron Grantham, Daisha J. Cipher, Georgios Christopoulos, Bavana V. Rangan, Robert W. Yeh, Muhammad Nauman J Tarar, Emmanouil S. Brilakis, Santiago Garcia, Jeffrey W. Moses, Michael R. Wyman, Subhash Banerjee, Craig A. Thompson, Farouc A. Jaffer, Nicholas Lembo, William Lombardi, David E. Kandzari, Dimitri Karmpaliotis, Georgios E. Christakopoulos |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis business.industry medicine.medical_treatment Percutaneous coronary intervention 030204 cardiovascular system & hematology Surgery 03 medical and health sciences 0302 clinical medicine Coronary occlusion Predictive value of tests Severity of illness Conventional PCI Emergency medicine medicine 030212 general & internal medicine business Cardiology and Cardiovascular Medicine Chi-squared distribution TIMI |
| Zdroj: | JACC: Cardiovascular Interventions. 9(1):1-9 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2015.09.022 |
| Popis: | Objectives This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. Background Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. Methods We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. Results Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of “interventional” collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = −0.093 to 0.144). Conclusions The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach. |
| Databáze: | OpenAIRE |
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