TY - JOUR
T1 - Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions
T2 - The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score
AU - Danek, Barbara Anna
AU - Karatasakis, Aris
AU - Karmpaliotis, Dimitri
AU - Alaswad, Khaldoon
AU - Yeh, Robert W.
AU - Jaffer, Farouc A.
AU - Patel, Mitul P.
AU - Mahmud, Ehtisham
AU - Lombardi, William L.
AU - Wyman, Michael R.
AU - Aaron Grantham, J.
AU - Doing, Anthony
AU - Kandzari, David E.
AU - Lembo, Nicholas J.
AU - Garcia, Santiago
AU - Toma, Catalin
AU - Moses, Jeffrey W.
AU - Kirtane, Ajay J.
AU - Parikh, Manish A.
AU - Ali, Ziad A.
AU - Karacsonyi, Judit
AU - Rangan, Bavana V.
AU - Thompson, Craig A.
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
Study data were collected and managed using REDCap electronic data capture tools hosted at University of Texas Southwestern Medical Center. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for importing data from external sources.
Publisher Copyright:
© 2016 The Authors.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background--High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. Methods and Results--We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8%) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age > 65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4%, 1.8%, 6.5%, P < 0.001; validation cohort 0.0%, 2.5%, 6.8%, P < 0.001). Conclusions--The PROGRESS CTO complication score is a useful tool for prediction of periprocedural complications in CTO PCI.
AB - Background--High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. Methods and Results--We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8%) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age > 65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4%, 1.8%, 6.5%, P < 0.001; validation cohort 0.0%, 2.5%, 6.8%, P < 0.001). Conclusions--The PROGRESS CTO complication score is a useful tool for prediction of periprocedural complications in CTO PCI.
KW - Chronic total occlusion
KW - Complication
KW - Outcome
KW - Percutaneous coronary intervention
KW - Risk stratification
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U2 - 10.1161/JAHA.116.004272
DO - 10.1161/JAHA.116.004272
M3 - Article
C2 - 27729332
AN - SCOPUS:84994391777
SN - 2047-9980
VL - 5
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 10
M1 - e004272
ER -
