Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention

Aris Karatasakis; Barbara A. Danek; Dimitri Karmpaliotis; Khaldoon Alaswad; Farouc A. Jaffer; Robert W. Yeh; Mitul Patel; John N. Bahadorani; William L. Lombardi; R. Michael Wyman; J. Aaron Grantham; David E. Kandzari; Nicholas J. Lembo; Anthony H. Doing; Catalin Toma; Jeffrey W. Moses; Ajay J. Kirtane; Manish A. Parikh; Ziad A. Ali; Santiago Garcia; Pratik Kalsaria; Judit Karacsonyi; Aya J. Alame; Craig A. Thompson; Subhash Banerjee; Emmanouil S. Brilakis

doi:10.1016/j.ijcard.2016.08.317

Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention

Aris Karatasakis, Barbara A. Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A. Jaffer, Robert W. Yeh, Mitul Patel, John N. Bahadorani, William L. Lombardi, R. Michael Wyman, J. Aaron Grantham, David E. Kandzari, Nicholas J. Lembo, Anthony H. Doing, Catalin Toma, Jeffrey W. Moses, Ajay J. Kirtane, Manish A. Parikh, Ziad A. Ali, Santiago GarciaPratik Kalsaria, Judit Karacsonyi, Aya J. Alame, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

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41 Scopus citations

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.

Original language	English (US)
Pages (from-to)	50-56
Number of pages	7
Journal	International Journal of Cardiology
Volume	224
DOIs	https://doi.org/10.1016/j.ijcard.2016.08.317
State	Published - Dec 1 2016

Keywords

Chronic total occlusion
Complications
Outcomes
Percutaneous coronary intervention
Procedural success
Techniques

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.ijcard.2016.08.317

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Karatasakis, A., Danek, B. A., Karmpaliotis, D., Alaswad, K., Jaffer, F. A., Yeh, R. W., Patel, M., Bahadorani, J. N., Lombardi, W. L., Wyman, R. M., Grantham, J. A., Kandzari, D. E., Lembo, N. J., Doing, A. H., Toma, C., Moses, J. W., Kirtane, A. J., Parikh, M. A., Ali, Z. A., ... Brilakis, E. S. (2016). Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention. International Journal of Cardiology, 224, 50-56. https://doi.org/10.1016/j.ijcard.2016.08.317

Karatasakis, A, Danek, BA, Karmpaliotis, D, Alaswad, K, Jaffer, FA, Yeh, RW, Patel, M, Bahadorani, JN, Lombardi, WL, Wyman, RM, Grantham, JA, Kandzari, DE, Lembo, NJ, Doing, AH, Toma, C, Moses, JW, Kirtane, AJ, Parikh, MA, Ali, ZA, Garcia, S, Kalsaria, P, Karacsonyi, J, Alame, AJ, Thompson, CA, Banerjee, S & Brilakis, ES 2016, 'Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention', International Journal of Cardiology, vol. 224, pp. 50-56. https://doi.org/10.1016/j.ijcard.2016.08.317

@article{0b8ef1d88d294124a35b03b247eb0903,

title = "Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention",

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.",

keywords = "Chronic total occlusion, Complications, Outcomes, Percutaneous coronary intervention, Procedural success, Techniques",

author = "Aris Karatasakis and Danek, {Barbara A.} and Dimitri Karmpaliotis and Khaldoon Alaswad and Jaffer, {Farouc A.} and Yeh, {Robert W.} and Mitul Patel and Bahadorani, {John N.} and Lombardi, {William L.} and Wyman, {R. Michael} and Grantham, {J. Aaron} and Kandzari, {David E.} and Lembo, {Nicholas J.} and Doing, {Anthony H.} and Catalin Toma and Moses, {Jeffrey W.} and Kirtane, {Ajay J.} and Parikh, {Manish A.} and Ali, {Ziad A.} and Santiago Garcia and Pratik Kalsaria and Judit Karacsonyi and Alame, {Aya J.} and Thompson, {Craig A.} and Subhash Banerjee and Brilakis, {Emmanouil S.}",

note = "Publisher Copyright: {\textcopyright} 2016",

year = "2016",

month = dec,

day = "1",

doi = "10.1016/j.ijcard.2016.08.317",

language = "English (US)",

volume = "224",

pages = "50--56",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention

AU - Karatasakis, Aris

AU - Danek, Barbara A.

AU - Karmpaliotis, Dimitri

AU - Alaswad, Khaldoon

AU - Jaffer, Farouc A.

AU - Yeh, Robert W.

AU - Patel, Mitul

AU - Bahadorani, John N.

AU - Lombardi, William L.

AU - Wyman, R. Michael

AU - Grantham, J. Aaron

AU - Kandzari, David E.

AU - Lembo, Nicholas J.

AU - Doing, Anthony H.

AU - Toma, Catalin

AU - Moses, Jeffrey W.

AU - Kirtane, Ajay J.

AU - Parikh, Manish A.

AU - Ali, Ziad A.

AU - Garcia, Santiago

AU - Kalsaria, Pratik

AU - Karacsonyi, Judit

AU - Alame, Aya J.

AU - Thompson, Craig A.

AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - 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.

AB - 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.

KW - Chronic total occlusion

KW - Complications

KW - Outcomes

KW - Percutaneous coronary intervention

KW - Procedural success

KW - Techniques

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UR - http://www.scopus.com/inward/citedby.url?scp=84986579064&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2016.08.317

DO - 10.1016/j.ijcard.2016.08.317

M3 - Article

C2 - 27611917

AN - SCOPUS:84986579064

SN - 0167-5273

VL - 224

SP - 50

EP - 56

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention

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