External validation of the PROGRESS-CTO complication risk scores: Individual patient data pooled analysis of 3 registries
Recommended Citation
Cardiology Simsek B, Tajti P, Carlino M, Ojeda S, Pan M, Rinfret S, Vemmou E, Kostantinis S, Nikolakopoulos I, Karacsonyi J, Dens JA, Agostoni P, Alaswad K, Megaly M, Avran A, Choi JW, Jaffer FA, Doshi D, Karmpaliotis D, Khatri JJ, Knaapen P, La Manna A, Spratt JC, Tanabe M, Walsh S, Mastrodemos OC, Allana S, Rempakos A, Rangan BV, Goktekin O, Gorgulu S, Poommipanit P, Kearney KE, Lombardi WL, Grantham JA, Mashayekhi K, Brilakis ES, and Azzalini L. External validation of the PROGRESS-CTO complication risk scores: Individual patient data pooled analysis of 3 registries. Int J Cardiol 2022.
Document Type
Article
Publication Date
2022
Publication Title
International journal of cardiology
Abstract
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.
Medical Subject Headings
Humans; Treatment Outcome; Percutaneous Coronary Intervention; Coronary Angiography; Risk Factors; Registries; Coronary Occlusion; Chronic Disease
PubMed ID
36565956
Volume
375
First Page
14
Last Page
20
