1. Evaluation of Success and Complications Scores for Chronic Total Occlusion Percutaneous Coronary Interventions: Insights from the Latin American Registry.
- Author
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Piccaro de Oliveira P, Abelin AP, Machado GP, Filho EM, Araujo GN, Côrtes LA, Padilla L, Peralta SP, Santiago R, de Paula JET, Botelho AC, Echavarria-Pinto M, Damas de Los Santos F, Harada M, Campos CM, and Quadros AS
- Subjects
- Humans, Latin America epidemiology, Chronic Disease, Male, Female, Middle Aged, Aged, Postoperative Complications epidemiology, Treatment Outcome, Prospective Studies, Coronary Occlusion surgery, Coronary Occlusion diagnosis, Percutaneous Coronary Intervention methods, Registries
- Abstract
Chronic total occlusion (CTO) percutaneous coronary intervention is a complex procedure and is associated with considerable risk of complications. Several success and complication scores have been developed; however, data regarding their external validation in other populations such as Latin America are scarce. This study aimed to evaluate the accuracy of the main predictors of success and complications in a broad cohort of procedures in the Latin American (LATAM) CTO registry. From April 2008 to December 2023, 3,706 consecutive procedures listed in the LATAM CTO registry were screened. Of these, 2,835 procedures had sufficient information to analyze the Multicenter CTO Registry in Japan (J-CTO); Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS); Ostial location, Rentrop grade, and Age (ORA); Clinical and Lesion-related Score (CL-score); and EuroCTO Score (CASTLE) success scores. The complication scores were PROGRESS (MACE, mortality, and pericardiocentesis) and Outcomes, Patient health status, and Efficiency iN Chronic Total Occlusion hybrid procedures (OPEN-CTO),OPEN-CLEAN. The J-CTO and CASTLE scores demonstrated the highest areas under the curve (AUC) of 0.718 and 0.703, respectively. The AUC value for the CL-score was 0.685, whereas the PROGRESS score had an AUC of 0.598 and the ORA AUC was 0.545. The level of agreement between scores was low; only 4% of the procedures were classified as difficult or very difficult by all scores and <1% were classified as easy by all 5 scores. Of the complication scores, PROGRESS mortality (AUC 0.651) and PROGRESS MACE (AUC 0.588) showed the best performance, identifying groups with >10% event rate. These results may improve the selection of revascularization techniques, especially for patient demographics that are historically underrepresented in CTO research., Competing Interests: Declaration of competing interest Dr. Quadros receives financial support from Boston Scientific Corp., APT Medical, and Asahi Intecc Co. Ltd. Dr. Quadros receives speaking and lecture fees from APT Medical. The remaining authors have no competing interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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