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

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

来源：International Journal of Cardiology, 2016, 224: 50-56.

DOI：10.1016/j.ijcard.2016.08.317

• Chronic total occlusion
• Percutaneous coronary intervention
• Procedural success
• Complications
• Techniques
• Outcomes

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. Published by Elsevier Ireland Ltd.

• 出版日期2016-12-1