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External validation of the PROGRESS-CTO perforation risk score
- Source :
- Simsek, B, Tajti, P, Carlino, M, Ojeda, S, Pan, M, Rinfret, S, Vemmou, E, Kostantinis, S, Nikolakopoulos, I, Karacsonyi, J, Rempakos, A, Dens, J A, Agostoni, P, Alaswad, K, Megaly, M, Avran, A, Choi, J W, Jaffer, F A, Doshi, D, Karmpaliotis, D, Khatri, J J, Knaapen, P, la Manna, A, Spratt, J C, Tanabe, M, Walsh, S, Mastrodemos, O C, Allana, S, Rangan, B V, Goktekin, O, Gorgulu, S, Poommipanit, P, Kearney, K E, Lombardi, W L, Grantham, J A, Mashayekhi, K, Brilakis, E S & Azzalini, L 2023, ' External validation of the PROGRESS-CTO perforation risk score : Individual patient data pooled analysis of three registries ', Catheterization and Cardiovascular Interventions, vol. 101, no. 2, pp. 326-332 . https://doi.org/10.1002/ccd.30551, Catheterization and Cardiovascular Interventions, 101(2), 326-332. Wiley-Liss Inc.
- Publication Year :
- 2023
-
Abstract
- Background: Coronary artery perforation is one of the most feared and common complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: To assess the usefulness of the recently developed PROGRESS-CTO (NCT02061436) perforation risk score in independent cohorts. Individual patient-level data pooled analysis of three registries was performed. Results: Of the 4566 patients who underwent CTO PCI at 25 centers, 196 (4.2%) had coronary artery perforation. Patients with perforations were older (69 ± 10 vs. 65 ± 10, p < 0.001), more likely to be women (19% vs. 13%, p = 0.009), more likely to have a history of prior coronary artery bypass graft (34% vs. 20%, p < 0.001), and unfavorable angiographic characteristics such as blunt stump (62% vs. 48%, p < 0.001), proximal cap ambiguity (52% vs. 34%, p < 0.001), and moderate-severe calcification (60% vs. 49%, p = 0.002). Technical success was lower in patients with perforations (73% vs. 88%, p < 0.001). The area under the receiver operating characteristic curve of the PROGRESS-CTO perforation risk model was 0.76 (95% confidence interval [CI], 0.72−0.79), with good calibration (Hosmer-Lemeshow p = 0.97). We found that the CTO PCI perforation risk increased with higher PROGRESS-CTO perforation scores: 0.3% (score 0), 2.3% (score 1), 3.1% (score 2), 5.5% (score 3), 7.5% (score 4), 14.6% (score 5). Conclusion: Given the good discriminative performance, calibration, and the ease of calculation, the PROGRESS-CTO perforation score may facilitate assessment of the risk of perforation in patients undergoing CTO PCI.
Details
- Language :
- English
- ISSN :
- 15221946
- Volume :
- 101
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....1887a79f141267238f33e716660a5bd1