Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions: The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score

Barbara Anna Danek, Aris Karatasakis, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W. Yeh, Farouc A. Jaffer, Mitul P. Patel, Ehtisham Mahmud, William L. Lombardi, Michael R. Wyman, J. Aaron Grantham, Anthony Doing, David E. Kandzari, Nicholas J. Lembo, Santiago Garcia, Catalin Toma, Jeffrey W. Moses, Ajay J. Kirtane, Manish A. Parikh, Ziad A. AliJudit Karacsonyi, Bavana V. Rangan, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background--High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. Methods and Results--We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8%) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age > 65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4%, 1.8%, 6.5%, P < 0.001; validation cohort 0.0%, 2.5%, 6.8%, P < 0.001). Conclusions--The PROGRESS CTO complication score is a useful tool for prediction of periprocedural complications in CTO PCI.

Original languageEnglish (US)
Article numbere004272
JournalJournal of the American Heart Association
Volume5
Issue number10
DOIs
StatePublished - 2016

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Percutaneous Coronary Intervention
Registries
ROC Curve
Odds Ratio
Calibration

Keywords

  • Chronic total occlusion
  • Complication
  • Outcome
  • Percutaneous coronary intervention
  • Risk stratification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions : The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score. / Danek, Barbara Anna; Karatasakis, Aris; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Yeh, Robert W.; Jaffer, Farouc A.; Patel, Mitul P.; Mahmud, Ehtisham; Lombardi, William L.; Wyman, Michael R.; Aaron Grantham, J.; Doing, Anthony; Kandzari, David E.; Lembo, Nicholas J.; Garcia, Santiago; Toma, Catalin; Moses, Jeffrey W.; Kirtane, Ajay J.; Parikh, Manish A.; Ali, Ziad A.; Karacsonyi, Judit; Rangan, Bavana V.; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Journal of the American Heart Association, Vol. 5, No. 10, e004272, 2016.

Research output: Contribution to journalArticle

Danek, BA, Karatasakis, A, Karmpaliotis, D, Alaswad, K, Yeh, RW, Jaffer, FA, Patel, MP, Mahmud, E, Lombardi, WL, Wyman, MR, Aaron Grantham, J, Doing, A, Kandzari, DE, Lembo, NJ, Garcia, S, Toma, C, Moses, JW, Kirtane, AJ, Parikh, MA, Ali, ZA, Karacsonyi, J, Rangan, BV, Thompson, CA, Banerjee, S & Brilakis, ES 2016, 'Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions: The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score', Journal of the American Heart Association, vol. 5, no. 10, e004272. https://doi.org/10.1161/JAHA.116.004272
Danek, Barbara Anna ; Karatasakis, Aris ; Karmpaliotis, Dimitri ; Alaswad, Khaldoon ; Yeh, Robert W. ; Jaffer, Farouc A. ; Patel, Mitul P. ; Mahmud, Ehtisham ; Lombardi, William L. ; Wyman, Michael R. ; Aaron Grantham, J. ; Doing, Anthony ; Kandzari, David E. ; Lembo, Nicholas J. ; Garcia, Santiago ; Toma, Catalin ; Moses, Jeffrey W. ; Kirtane, Ajay J. ; Parikh, Manish A. ; Ali, Ziad A. ; Karacsonyi, Judit ; Rangan, Bavana V. ; Thompson, Craig A. ; Banerjee, Subhash ; Brilakis, Emmanouil S. / Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions : The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score. In: Journal of the American Heart Association. 2016 ; Vol. 5, No. 10.
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title = "Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions: The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score",
abstract = "Background--High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. Methods and Results--We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8{\%}) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age > 65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4{\%}, 1.8{\%}, 6.5{\%}, P < 0.001; validation cohort 0.0{\%}, 2.5{\%}, 6.8{\%}, P < 0.001). Conclusions--The PROGRESS CTO complication score is a useful tool for prediction of periprocedural complications in CTO PCI.",
keywords = "Chronic total occlusion, Complication, Outcome, Percutaneous coronary intervention, Risk stratification",
author = "Danek, {Barbara Anna} and Aris Karatasakis and Dimitri Karmpaliotis and Khaldoon Alaswad and Yeh, {Robert W.} and Jaffer, {Farouc A.} and Patel, {Mitul P.} and Ehtisham Mahmud and Lombardi, {William L.} and Wyman, {Michael R.} and {Aaron Grantham}, J. and Anthony Doing and Kandzari, {David E.} and Lembo, {Nicholas J.} and Santiago Garcia and Catalin Toma and Moses, {Jeffrey W.} and Kirtane, {Ajay J.} and Parikh, {Manish A.} and Ali, {Ziad A.} and Judit Karacsonyi and Rangan, {Bavana V.} and Thompson, {Craig A.} and Subhash Banerjee and Brilakis, {Emmanouil S.}",
year = "2016",
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language = "English (US)",
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TY - JOUR

T1 - Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions

T2 - The prospective global registry for the study of chronic total occlusion intervention (progress cto) complications score

AU - Danek, Barbara Anna

AU - Karatasakis, Aris

AU - Karmpaliotis, Dimitri

AU - Alaswad, Khaldoon

AU - Yeh, Robert W.

AU - Jaffer, Farouc A.

AU - Patel, Mitul P.

AU - Mahmud, Ehtisham

AU - Lombardi, William L.

AU - Wyman, Michael R.

AU - Aaron Grantham, J.

AU - Doing, Anthony

AU - Kandzari, David E.

AU - Lembo, Nicholas J.

AU - Garcia, Santiago

AU - Toma, Catalin

AU - Moses, Jeffrey W.

AU - Kirtane, Ajay J.

AU - Parikh, Manish A.

AU - Ali, Ziad A.

AU - Karacsonyi, Judit

AU - Rangan, Bavana V.

AU - Thompson, Craig A.

AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

PY - 2016

Y1 - 2016

N2 - Background--High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. Methods and Results--We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8%) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age > 65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4%, 1.8%, 6.5%, P < 0.001; validation cohort 0.0%, 2.5%, 6.8%, P < 0.001). Conclusions--The PROGRESS CTO complication score is a useful tool for prediction of periprocedural complications in CTO PCI.

AB - Background--High success rates are achievable for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid approach, but periprocedural complications remain of concern. Although scores estimating success and efficiency in CTO PCI have been developed, there is currently no available score for estimation of the risk for periprocedural complications. We sought to develop a scoring tool for prediction of periprocedural complications during CTO PCI. Methods and Results--We analyzed data from 1569 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) using a derivation and validation sampling ratio of 2:1. Variables independently associated with periprocedural complications in multivariable analysis in the derivation set were assigned points based on their respective odds ratios. Forty-four (2.8%) patients experienced complications. Three factors were independent predictors of complications and were included in the score: patient age > 65 years, +3 points (odds ratio, OR=4.85, CI 1.82-16.77); lesion length ≥23 mm, +2 points (OR=3.22, CI 1.08-13.89); and use of the retrograde approach +1 point (OR=2.41, CI 1.04-6.05). The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow χ2 6.271, P=0.281, receiver-operating characteristic [ROC] area=0.758) and validation (Hosmer-Lemeshow χ2 4.551, P=0.473, ROC area=0.793) sets. Score values of 0 to 2, 3 to 4, and ≥5 were defined as low, intermediate, and high risk of complications (derivation cohort 0.4%, 1.8%, 6.5%, P < 0.001; validation cohort 0.0%, 2.5%, 6.8%, P < 0.001). Conclusions--The PROGRESS CTO complication score is a useful tool for prediction of periprocedural complications in CTO PCI.

KW - Chronic total occlusion

KW - Complication

KW - Outcome

KW - Percutaneous coronary intervention

KW - Risk stratification

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U2 - 10.1161/JAHA.116.004272

DO - 10.1161/JAHA.116.004272

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AN - SCOPUS:84994391777

VL - 5

JO - Journal of the American Heart Association

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