Performance of J-CTO and PROGRESS CTO Scores in Predicting Angiographic Success and Long-term Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusions

Forouzandeh, Farshad; Suh, Jon; Stahl, Eric; Ko, Yi An; Lee, Suegene; Joshi, Udit; Sabharwal, Nitin; Almuwaqqat, Zakaria; Gandhi, Rounak; Lee, Hee Su; Ahn, Sung Gyun; Gogas, Bill D.; Douglas, John S.; Robertson, Gregory; Karmpaliotis, Dimitri; Brilakis, Emmanouil S.; Nicholson, William J.; King, Spencer B.; Samady, Habib

doi:10.1016/j.amjcard.2017.09.013

Cited by 31 publications

(25 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many studies have suggested a long-term survival advantage for CABG compared with PCI in patients with multi-vessel coronary artery disease [10] . Moreover, the success rate of LCX-CTO was the lowest; many studies have con rmed that the successful opening of LCX-CTO has not seen obvious clinical bene ts [11] , and LCX-CTO is more di cult to open, one of the diagnostic criteria of the PROGRESS-CTO score is LCX-CTO [12] .…”

Section: Discussionmentioning

confidence: 99%

The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World

Gong

Zhou

Ding

et al. 2020

Preprint

View full text Add to dashboard Cite

Backgroud: Chronic total occlusions (CTOs) are an important and increasingly recognized subgroup of coronary lesions; the optimal treatment strategy for CTO has not been well established. We sought to examine the impact of CTO percutaneous coronary intervention (PCI) on long-term clinical outcome in the real world.Methods: A total of 592 consecutive patients with CTO in Beijing Friendship Hospital from June 2017 to December 2019 were enrolled. 29 patients were excluded due to Coronary artery bypass grafting (CABG), 301 patients were revascularized by PCI (CTO-R group) and 262 were not revascularized (CTO-NR group). The primary endpoint was cardiac death; Secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, cardiac death, recurrent myocardial infarction, target lesion revascularization, re-hospitalization, heart failure, and stroke. Results: Percent of Diabetes mellitus (53.4% vs 39.5), Chronic kidney disease (8.8% vs 3.7%), CABG history (7.6% vs 1%), three vessel disease(96.2% vs 90%) and LM disease(25.2% vs 13.6%) was significantly higher in the CTO-NR group than in success PCI group (all P<0.05). Moreover, the CTO-NR group has lower EF (0.58±0.11 vs 0.61±0.1, p=0.002) and FS (0.32±0.07 vs 0.33±0.07, p=0.003). At a median follow-up of 12 months, CTO-R was superior to CTO-NR in terms of cardiac death (adjusted hazard ratio [HR]: 0.32, 95% conference interval [CI] 0.11-0.94). The superiority of CTO-R was consistent for MACCE (HR: 0.57, 95% CI 0.37-0.87). At multivariable Cox hazards regression analysis, CTO-R remains one of the independent predictors of lower risk of cardiac death and MACCE.Conclusions: Successful revascularization by PCI offered CTO patients more clinical benefits. The presence of LVEF＜0.5 and LM-disease was associated with an incidence of cardiac death; CTO revascularised was a protected predictor of cardiac death.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World

Gong

Zhou

Ding

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…16 The clinical and lesion-related (CL) score 17 is primarily focused on antegrade procedures, and hence, it would be more useful for antegrade-only operators. On the other hand, the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) score, 18 the ORA (ostial location, Rentrop grade <2, age ≥75 years) score 19 and the Castle (EUROCTO club) 20 may be more suitable for predicting recanalization success in retrograde or hybrid procedures. Additionally, the PROGRESS-CTO complication score assesses the preoperative risk of complications using three variables (age ≥65 years, lesion length >23mm, and use of the retrograde approach).…”

Section: Preoperative Planningmentioning

confidence: 99%

Retrograde approach for percutaneous treatment of chronic total occlusions of coronary arteries

Paula¹,

Falcão²,

Silva³

2020

J Transcat Intervent

View full text Add to dashboard Cite

Coronary artery chronic total occlusions are diagnosed in about 20% of coronary angiograms, nevertheless, percutaneous recanalization of these lesions is under attempted. Theses patients usually have incomplete percutaneous revascularization or are referred for coronary artery bypass surgery. Current improvements in the interventional armamentarium along with innovative approaches led to a marked increase in recanalization success rates, even in the most complex anatomic scenarios. Retrograde approach techniques are considered an essential part of the skillset for chronic total occlusion dedicated operators, and is probably the most difficult step to master. Refinements in the retrograde technique were paramount to achieve the safety and efficacy current standards. The authors propose a step-by-step guide for operators wanting to embrace this strategy.

show abstract

“…To select between the CTO-PCI and CABG procedures, we should consider the initial success rates and chronic outcomes, including revascularization. The performance of the PROGRESS CTO score for the prediction of long-term outcomes was tested recently, and the score was associated with the MACCE risk, albeit vigorous statistical adjustment was not performed [13]. To clarify the risk estimation of MACCE and refining the indication for CTO-PCI, a universal risk stratification was needed for assessing CTO-PCI as a suitable option for the treatment of ischemic heart disease.…”

Section: Plos Onementioning

confidence: 99%

“…However, these risk models do not effectively predict long-term outcomes following the procedure. Recently, the Prospective Global Registry for the Study of CTO Intervention (PROGRESS CTO) [11] score, developed to predict the success of CTO-PCIs, was reported to be a useful tool in predicting long-term outcomes [13], albeit the study population was small and the procedural success rates were lower than that in conventional CTO studies [7].…”

Section: Introductionmentioning

confidence: 99%

Derivation and validation of the J-CTO extension score for pre-procedural prediction of major adverse cardiac and cerebrovascular events in patients with chronic total occlusions

et al. 2020

View full text Add to dashboard Cite

We developed a prediction model of long-term risk after percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) based on pre-procedural clinical information. A total of 4,139 eligible patients, who underwent CTO-PCI at 52 Japanese centers were included. Specifically, 1,909 patients with 1-year data were randomly divided into the derivation (n = 1,273) and validation (n = 636) groups. Major adverse cardiac and cardiovascular event (MACCE) was the primary endpoint, including death, stroke, revascularization, and non-fatal myocardial infarction. We assessed the performance of our model using the area under the receiver operating characteristic curve (AUC) and assigned a simplified point-scoring system. One-hundred-thirty-eight (10.8%) patients experienced MACCE in the derivation cohort with hemodialysis (HD: odds ratio [OR] = 2.55), left ventricular ejection fractions (LVEF) <35% (OR = 2.23), in-stent occlusions (ISO: OR = 2.27), and diabetes mellitus (DM: OR = 1.72). The AUC of the derivation model was 0.650. The model's performance was similar in the validation cohort (AUC, 0.610). When assigned a point for each associated factor (HD = 3, LVEF <35%, ISO = 2, and DM = 1 point), the average predicted versus the observed MACCE probability using the Japan-CTO extension score for the low, moderate, high, and very high risk groups was 8.1% vs. 7.3%, 16.9% vs. 15.9%, 22.0% vs. 26.1%, and 56.2% vs. 44.4%, respectively. This novel risk model may allow for the estimation of long-term risk and be useful in disseminating appropriate revascularization procedures.

show abstract

Performance of J-CTO and PROGRESS CTO Scores in Predicting Angiographic Success and Long-term Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusions

Cited by 31 publications

References 23 publications

The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World

The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World

Retrograde approach for percutaneous treatment of chronic total occlusions of coronary arteries

Derivation and validation of the J-CTO extension score for pre-procedural prediction of major adverse cardiac and cerebrovascular events in patients with chronic total occlusions

Contact Info

Product

Resources

About