TY - JOUR
T1 - External validation of the PROGRESS-CTO perforation risk score
T2 - Individual patient data pooled analysis of three registries
AU - Simsek, Bahadir
AU - Tajti, Peter
AU - Carlino, Mauro
AU - Ojeda, Soledad
AU - Pan, Manuel
AU - Rinfret, Stephane
AU - Vemmou, Evangelia
AU - Kostantinis, Spyridon
AU - Nikolakopoulos, Ilias
AU - Karacsonyi, Judit
AU - Rempakos, Athanasios
AU - Dens, Joseph A.
AU - Agostoni, Pierfrancesco
AU - Alaswad, Khaldoon
AU - Megaly, Michael
AU - Avran, Alexandre
AU - Choi, James W.
AU - Jaffer, Farouc A.
AU - Doshi, Darshan
AU - Karmpaliotis, Dimitri
AU - Khatri, Jaikirshan J.
AU - Knaapen, Paul
AU - la Manna, Alessio
AU - Spratt, James C.
AU - Tanabe, Masaki
AU - Walsh, Simon
AU - Mastrodemos, Olga C.
AU - Allana, Salman
AU - Rangan, Bavana V.
AU - Goktekin, Omer
AU - Gorgulu, Sevket
AU - Poommipanit, Paul
AU - Kearney, Kathleen E.
AU - Lombardi, William L.
AU - Grantham, J. Aaron
AU - Mashayekhi, Kambis
AU - Brilakis, Emmanouil S.
AU - Azzalini, Lorenzo
N1 - Funding Information:
The authors are grateful for the philanthropic support of our generous anonymous donors, and the philanthropic support of Drs. Mary Ann and Donald A Sens; Mrs. Diane and Dr. Cline Hickok; Mrs. Wilma and Mr. Dale Johnson; Mrs. Charlotte and Mr. Jerry Golinvaux Family Fund; the Roehl Family Foundation; the Joseph Durda Foundation. The generous gifts of these donors to the Minneapolis Heart Institute Foundation's Science Center for Coronary Artery Disease (CCAD) helped support this research project.
Funding Information:
The authors are grateful for the philanthropic support of our generous anonymous donors, and the philanthropic support of Drs. Mary Ann and Donald A Sens; Mrs. Diane and Dr. Cline Hickok; Mrs. Wilma and Mr. Dale Johnson; Mrs. Charlotte and Mr. Jerry Golinvaux Family Fund; the Roehl Family Foundation; the Joseph Durda Foundation. The generous gifts of these donors to the Minneapolis Heart Institute Foundation's Science Center for Coronary Artery Disease (CCAD) helped support this research project.
Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - 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.
AB - 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.
KW - chronic total occlusion
KW - external validation
KW - major adverse cardiovascular events
KW - mortality
KW - percutaneous coronary intervention
KW - prediction
KW - risk model
UR - https://www.scopus.com/pages/publications/85146065040
U2 - 10.1002/ccd.30551
DO - 10.1002/ccd.30551
M3 - Article
C2 - 36617391
SN - 1522-1946
VL - 101
SP - 326
EP - 332
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 2
ER -