TY - JOUR
T1 - External validation of the PROGRESS-CTO complication risk scores
T2 - Individual patient data pooled analysis of 3 registries
AU - Simsek, Bahadir
AU - Tajti, Peter
AU - Carlino, Mauro
AU - Ojeda, Soledad
AU - Pan, Manuel
AU - Rinfret, Stephane
AU - Vemmou, Evangelia
AU - Kostantinis, Spyridon
AU - Nikolakopoulos, Ilias
AU - Karacsonyi, Judit
AU - Dens, Joseph A.
AU - Agostoni, Pierfrancesco
AU - Alaswad, Khaldoon
AU - Megaly, Michael
AU - Avran, Alexandre
AU - Choi, James W.
AU - Jaffer, Farouc A.
AU - Doshi, Darshan
AU - Karmpaliotis, Dimitri
AU - Khatri, Jaikirshan J.
AU - Knaapen, Paul
AU - La Manna, Alessio
AU - Spratt, James C.
AU - Tanabe, Masaki
AU - Walsh, Simon
AU - Mastrodemos, Olga C.
AU - Allana, Salman
AU - Rempakos, Athanasios
AU - Rangan, Bavana V.
AU - Goktekin, Omer
AU - Gorgulu, Sevket
AU - Poommipanit, Paul
AU - Kearney, Kathleen E.
AU - Lombardi, William L.
AU - Grantham, J. Aaron
AU - Mashayekhi, Kambis
AU - Brilakis, Emmanouil S.
AU - Azzalini, Lorenzo
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2023/3/15
Y1 - 2023/3/15
N2 - Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with a considerable risk of complications, and risk stratification is of utmost importance. Aims: To assess the clinical usefulness of the recently developed PROGRESS-CTO (NCT02061436) complication risk scores in an independent cohort. Methods: Individual patient data pooled analysis of 3 registries was performed. Results: Of the 4569 patients who underwent CTO PCI, 102 (2.2%) had major adverse cardiovascular events (MACE). Patients with MACE were older (69 ± 11 vs. 65 ± 10, p < 0.001), more likely to have a history of prior coronary artery bypass graft surgery, and unfavorable angiographic characteristics J-CTO score (2.4 ± 1.2 vs. 2.1 ± 1.3, p = 0.007), including blunt stump (59% vs. 49%, p = 0.047). Technical success was lower in patients with MACE (59% vs. 86%, p < 0.001). The area under the receiver operating characteristic curve of the PROGRESS-CTO complication risk models were as follows: MACE 0.72 (95% confidence interval [CI], 0.67–0.76), mortality 0.73 (95% CI, 0.61–0.85), and pericardiocentesis 0.69 (95% CI, 0.62–0.77) in the validation dataset. The observed complication rates increased with higher PROGRESS-CTO complication scores. The PROGRESS-CTO MACE score showed good calibration in this external cohort, with MACE rates similar to the original study: 0.7% (score 0–1), 1.5% (score 2), 2.2% (score 3), 3.8% (score 4), 4.9% (score 5), 5.8% (score 6–7). Conclusion: Given the good discriminative performance, calibration, and ease of calculation, the PROGRESS-CTO complication scores could help assess the risk of complications in patients undergoing CTO PCI.
AB - Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with a considerable risk of complications, and risk stratification is of utmost importance. Aims: To assess the clinical usefulness of the recently developed PROGRESS-CTO (NCT02061436) complication risk scores in an independent cohort. Methods: Individual patient data pooled analysis of 3 registries was performed. Results: Of the 4569 patients who underwent CTO PCI, 102 (2.2%) had major adverse cardiovascular events (MACE). Patients with MACE were older (69 ± 11 vs. 65 ± 10, p < 0.001), more likely to have a history of prior coronary artery bypass graft surgery, and unfavorable angiographic characteristics J-CTO score (2.4 ± 1.2 vs. 2.1 ± 1.3, p = 0.007), including blunt stump (59% vs. 49%, p = 0.047). Technical success was lower in patients with MACE (59% vs. 86%, p < 0.001). The area under the receiver operating characteristic curve of the PROGRESS-CTO complication risk models were as follows: MACE 0.72 (95% confidence interval [CI], 0.67–0.76), mortality 0.73 (95% CI, 0.61–0.85), and pericardiocentesis 0.69 (95% CI, 0.62–0.77) in the validation dataset. The observed complication rates increased with higher PROGRESS-CTO complication scores. The PROGRESS-CTO MACE score showed good calibration in this external cohort, with MACE rates similar to the original study: 0.7% (score 0–1), 1.5% (score 2), 2.2% (score 3), 3.8% (score 4), 4.9% (score 5), 5.8% (score 6–7). Conclusion: Given the good discriminative performance, calibration, and ease of calculation, the PROGRESS-CTO complication scores could help assess the risk of complications in patients undergoing CTO PCI.
KW - Chronic total occlusion
KW - External validation
KW - Major adverse cardiovascular events
KW - Mortality
KW - Percutaneous coronary intervention
KW - Risk model
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U2 - 10.1016/j.ijcard.2022.12.036
DO - 10.1016/j.ijcard.2022.12.036
M3 - Article
C2 - 36565956
AN - SCOPUS:85147112776
SN - 0167-5273
VL - 375
SP - 14
EP - 20
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -