TCT-112 Predicting In-Hospital Acute Myocardial Infarction in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Acute Myocardial Infarction Score
Recommended Citation
Simsek B, Kostantinis S, Karacsonyi J, Alaswad K, Krestyaninov O, Khelimskii D, Davies R, Rier J, Goktekin O, Gorgulu S, ElGuindy A, Chandwaney R, Patel M, Karmpaliotis D, Khatri J, Jaffer F, Poommipanit P, Rangan B, Sandoval Y, Elbarouni B, Nicholson W, Rinfret S, Koutouzis M, Tsiafoutis I, Yeh R, Burke M, Allana S, Mastrodemos O, Brilakis E. TCT-112 Predicting In-Hospital Acute Myocardial Infarction in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Acute Myocardial Infarction Score. J Am Coll Cardiol 2022; 80(12):B46.
Document Type
Conference Proceeding
Publication Date
9-20-2022
Publication Title
J Am Coll Cardiol
Abstract
Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with increased risk of periprocedural complications. Estimating the risk of complications facilitates risk-benefit assessment and procedural planning. Methods: We analyzed the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO; NCT02061436) and created a risk score for periprocedural acute myocardial infraction (MI). Logistic regression prediction modeling was used to identify independently associated variables and the model was internally validated with bootstrapping. Results: Of the 10,480 CTO PCI cases performed between 2012 and 2022 at 40 US and non-US centers, periprocedural MI occurred in 66 (0.63%). The final prediction model included 5 variables, of which 3 were independent predictors of acute MI: prior coronary artery bypass graft: odds ratio (OR) 2.44, 95% confidence interval (CI) 1.15-5.17, 1 point; atrial fibrillation: OR 2.39, 95% CI, 1.05-5.47, 1 point; and blunt stump, OR 2.70, 95% CI 1.22-5.98, 1 point; prior MI (not significant); and diabetes mellitus (not significant); with a bootstrap corrected c-statistic of 0.72 (95% CI, 0.65-0.80). The calculated risk percentages for acute MI based on the PROGRESS-CTO acute MI risk score ranged from 0.18% to 2.83% for acute MI, and 87% of patients had PROGRESS-CTO acute MI risk score of 0 or 1, corresponding to an acute MI risk of 0.18%-0.50% (Figure). [Formula presented] Conclusion: The PROGRESS-CTO in-hospital acute MI risk score can facilitate risk-benefit assessment and procedural planning in patients undergoing CTO PCI. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)
Volume
80
Issue
12
First Page
B46
