Validation of the coronary artery specific chronic total occlusion percutaneous coronary intervention angiographic difficulty scores in the PROGRESS-CTO registry
Recommended Citation
Mutlu D, Simsek B, Rempakos A, Alexandrou M, Al-Ogaili A, Azzalini L, Rinfret S, Khatri JJ, Alaswad K, Jaffer FA, Jaber W, Basir MB, Goktekin O, Gorgulu S, Krestyaninov O, Khelimskii D, Davies R, Frizzel J, Choi JW, Chandwaney RH, Potluri S, Poommipanit P, Uretsky B, Ybarra LF, Murad B, Rangan BV, Mastrodemos OC, Sandoval Y, Burke MN, and Brilakis ES. Validation of the coronary artery specific chronic total occlusion percutaneous coronary intervention angiographic difficulty scores in the PROGRESS-CTO registry. Cardiovasc Revasc Med 2024.
Document Type
Article
Publication Date
10-28-2024
Publication Title
Cardiovasc Revasc Med
Abstract
BACKGROUND: The J-CTO investigators recently developed angiographic difficulty scores for each of the three major coronary arteries in patients undergoing first-attempt chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in de novo occlusions.
METHODS: We examined the performance of the individual J-CTO scores in a large multicenter registry.
RESULTS: The CTO lesion location was as follows: right coronary artery (RCA) 3,805 (54%), left anterior descending artery (LAD) 2,303 (33%), and left circumflex (LCX) 935 (13%). Patients in the PROGRESS-CTO registry were younger, more likely to be female, and had higher J-CTO scores compared with the J-CTO registry. Increasing difficulty scores were associated with lower technical success in the PROGRESS-CTO registry (score 0: 94.4 % - score ≥3: 82.6% for the RCA difficulty score; score 0: 96.4% - score ≥3: 86.1 for the LAD difficulty score; and score 0: 95.4% - score ≥3: 81.2% for the LCX difficulty score). The C-statistic of the coronary artery specific J-CTO scores in the PROGRESS-CTO registry were: LAD 0.69 (95% confidence intervals [CI], 0.64-0.73), LCX 0.63 (95% CI, 0.57-0.69), and RCA 0.61 (95-% CI, 0.58-0.64) with good calibration (Hosmer-Lemeshow p-value >0.05 for all). The AUC of the classic J-CTO score for LAD lesions was similar with the LAD J-CTO score (p-for-difference = 0.26), but worse for LCX (p-for-difference = 0.04) and RCA lesions (p-for-difference = 0.04).
CONCLUSION: In the PROGRESS-CTO registry, the coronary artery specific J-CTO scores did not improve prediction of the technical success of CTO-PCI compared with the classic J-CTO score.
PubMed ID
39488482
ePublication
ePub ahead of print
