6533b824fe1ef96bd12814fb

RESEARCH PRODUCT

Choice of CTO scores to predict procedural success in clinical practice. A comparison of 4 different CTO PCI scores in a comprehensive national registry including expert and learning CTO operators

Javier Martín-moreirasIgnacio J. Amat-santosJuan Caballero BorregoJesús Jiménez-mazuecosGema MiñanaJulio NúñezPablo SalinasSergio RojasJosé M. De La Torre HernándezGuillermo GaleoteManuel FuentesEva RumizSandra Santos-martínezFernando LozanoSoledad OjedaJosé Antonio Fernández-díazJavier CuestaDaniela DuboisJavier LacunzaJavier GoicoleaJavier EscanedAlejandro Diego NietoAlfonso JuradoSergio Rodríguez-leirasManel SabatéVictoria Martin-yusteFrancisco J Morales-ponceJuan SanchisNieves GonzaloMiriam Jiménez-fernándezRaúl MillánAlejandro GutiérrezMaría M. LópezJuan RondanManuel PanFrancisco Bosa OjedaVíctor H MorenoBeatriz VaquerizoFernando RiveroJ. RoblesDae-hyun LeeMohsen Mohandes

subject

MaleCalibraciónCardiovascular ProceduresPhysiologymedicine.medical_treatmentMyocardial InfarctionSocial SciencesVasos coronariosCardiovascular MedicineSeverity of Illness IndexPercutaneous coronary intervention:Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Calibration [Medical Subject Headings]Learning and MemoryMedical ConditionsMedicine and Health SciencesPsychologyRegistries:Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings]Coronary Artery Bypass GraftingMultidisciplinaryQ:Analytical Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Endovascular Procedures::Percutaneous Coronary Intervention [Medical Subject Headings]RIntervención coronaria percutáneaMiddle AgedPrognosisInterventional CardiologyClinical PracticeTreatment Outcome:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Health Status Indicators::Patient Acuity::Severity of Illness Index [Medical Subject Headings]Cardiovascular DiseasesIntegrated discrimination improvementArea Under CurveCohortCalibrationMedicineFemaleResearch ArticleLearning Curvesmedicine.medical_specialtyCoronary StentingScienceCardiologyMEDLINE:Check Tags::Male [Medical Subject Headings]Surgical and Invasive Medical ProceduresCoronary arteryRisk AssessmentTotal occlusionCalcificationPercutaneous Coronary InterventionmedicineHumansLearningRegistrosAged:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings]business.industryAngioplasty:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment [Medical Subject Headings]Cognitive Psychology:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Area Under Curve [Medical Subject Headings]Biology and Life SciencesPercutaneous coronary intervention:Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings]Cardiovascular Disease Risk:Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Coronary Disease::Coronary Occlusion [Medical Subject Headings]Coronary Occlusion:Check Tags::Female [Medical Subject Headings]Stent ImplantationConventional PCIPhysical therapyCognitive Science:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings]National registry:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Registries [Medical Subject Headings]Physiological ProcessesbusinessCoronary AngioplastyNeuroscience

description

Background We aimed to compare the performance of the recent CASTLE score to J-CTO, CL and PROGRESS CTO scores in a comprehensive database of percutaneous coronary intervention of chronic total occlusion procedures. Methods Scores were calculated using raw data from 1,342 chronic total occlusion procedures included in REBECO Registry that includes learning and expert operators. Calibration, discrimination and reclassification were evaluated and compared. Results Mean score values were: CASTLE 1.60±1.10, J-CTO 2.15±1.24, PROGRESS 1.68±0.94 and CL 2.52±1.52 points. The overall percutaneous coronary intervention success rate was 77.8%. Calibration was good for CASTLE and CL, but not for J-CTO or PROGRESS scores. Discrimination: the area under the curve (AUC) of CASTLE (0.633) was significantly higher than PROGRESS (0.557) and similar to J-CTO (0.628) and CL (0.652). Reclassification: CASTLE, as assessed by integrated discrimination improvement, was superior to PROGRESS (integrated discrimination improvement +0.036, p<0.001), similar to J-CTO and slightly inferior to CL score (– 0.011, p = 0.004). Regarding net reclassification improvement, CASTLE reclassified better than PROGRESS (overall continuous net reclassification improvement 0.379, p<0.001) in roughly 20% of cases. Conclusion Procedural percutaneous coronary intervention difficulty is not consistently depicted by available chronic total occlusion scores and is influenced by the characteristics of each chronic total occlusion cohort. In our study population, including expert and learning operators, the CASTLE score had slightly better overall performance along with CL score. However, we found only intermediate performance in the c-statistic predicting chronic total occlusion success among all scores.

yearjournalcountryeditionlanguage
2021-04-02
10.1371/journal.pone.0245898https://hdl.handle.net/10668/4030