TY - JOUR
T1 - Clinical utility of the Japan-chronic total occlusion score in coronary chronic total occlusion interventions results from a multicenter registry
AU - Christopoulos, Georgios
AU - Wyman, Michael R.
AU - Alaswad, Khaldoon
AU - Karmpaliotis, Dimitri
AU - Lombardi, William
AU - Aaron Grantham, J.
AU - Yeh, Robert W.
AU - Jaffer, Farouc A.
AU - Cipher, Daisha J.
AU - Rangan, Bavana V.
AU - Christakopoulos, Georgios E.
AU - Kypreos, Megan A.
AU - Lembo, Nicholas
AU - Kandzari, David
AU - Garcia, Santiago
AU - Thompson, Craig A.
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2015 American Heart Association, Inc.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Background-The performance of the Japan-chronic total occlusion (J-CTO) score in predicting success and efficiency of CTO percutaneous coronary intervention has received limited study. Methods and Results-We examined the records of 650 consecutive patients who underwent CTO percutaneous coronary intervention between 2011 and 2014 at 6 experienced centers in the United States. Six hundred and fifty-seven lesions were classified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO3). The impact of the J-CTO score on technical success and procedure time was evaluated with univariable logistic and linear regression, respectively. The performance of the logistic regression model was assessed with the Hosmer-Lemeshow statistic and receiver operator characteristic curves. Antegrade wiring techniques were used more frequently in easy lesions (97%) than very difficult lesions (58%), whereas the retrograde approach became more frequent with increased lesion difficulty (41% for very difficult lesions versus 13% for easy lesions). The logistic regression model for technical success demonstrated satisfactory calibration and discrimination (P for Hosmer-Lemeshow =0.743 and area under curve =0.705). The J-CTO score was associated with a 2-fold increase in the odds of technical failure (odds ratio 2.04, 95% confidence interval 1.52-2.80, P0.001). Procedure time increased by 20 minutes for every 1-point increase of the J-CTO score (regression coefficient 22.33, 95% confidence interval 17.45-27.22, P0.001). Conclusions-J-CTO score was strongly associated with final success and efficiency in this study, supporting its expanded use in CTO interventions.
AB - Background-The performance of the Japan-chronic total occlusion (J-CTO) score in predicting success and efficiency of CTO percutaneous coronary intervention has received limited study. Methods and Results-We examined the records of 650 consecutive patients who underwent CTO percutaneous coronary intervention between 2011 and 2014 at 6 experienced centers in the United States. Six hundred and fifty-seven lesions were classified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO3). The impact of the J-CTO score on technical success and procedure time was evaluated with univariable logistic and linear regression, respectively. The performance of the logistic regression model was assessed with the Hosmer-Lemeshow statistic and receiver operator characteristic curves. Antegrade wiring techniques were used more frequently in easy lesions (97%) than very difficult lesions (58%), whereas the retrograde approach became more frequent with increased lesion difficulty (41% for very difficult lesions versus 13% for easy lesions). The logistic regression model for technical success demonstrated satisfactory calibration and discrimination (P for Hosmer-Lemeshow =0.743 and area under curve =0.705). The J-CTO score was associated with a 2-fold increase in the odds of technical failure (odds ratio 2.04, 95% confidence interval 1.52-2.80, P0.001). Procedure time increased by 20 minutes for every 1-point increase of the J-CTO score (regression coefficient 22.33, 95% confidence interval 17.45-27.22, P0.001). Conclusions-J-CTO score was strongly associated with final success and efficiency in this study, supporting its expanded use in CTO interventions.
KW - Chronic Total Occlusion
KW - Complication
KW - J-Cto Score
KW - Outcome
KW - Percutaneous Coronary Intervention
KW - Radiation
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U2 - 10.1161/CIRCINTERVENTIONS.114.002171
DO - 10.1161/CIRCINTERVENTIONS.114.002171
M3 - Article
C2 - 26162857
AN - SCOPUS:84939599520
SN - 1941-7640
VL - 8
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
IS - 7
M1 - e002171
ER -