Supplementary Material for: Predicting Successful Recanalization in Patients with Native Coronary Chronic Total Occlusion: The Busan CTO Score
Jin C.D.
Kim M.H.
Kim S.J.
Lee K.M.
Kim T.H.
Cho Y.-R.
Serebruany V.L.
10.6084/m9.figshare.4626157.v1
https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Predicting_Successful_Recanalization_in_Patients_with_Native_Coronary_Chronic_Total_Occlusion_The_Busan_CTO_Score/4626157
<p><b><i>Background:</i></b> The optimal strategy to manage chronic
total occlusion (CTO) remains unclear. The Japanese CTO multicenter
registry (J-CTO) score is an established tool for predicting successful
recanalization. However, it does not take into account nonangiographic
predictors for final technique success. In the present study, we
designed and tested a scoring model called the Busan single-center CTO
registry (B-CTO) score combining clinical and angiographic
characteristics to predict successful CTO recanalization in Korean
patients. <b><i>Methods:</i></b> Prospectively enrolled CTO patients (<i>n</i>
= 438) undergoing coronary intervention (1999-2015) were assessed. The
B-CTO score comprises 6 independent predictors: age 60-74 years and
lesion length ≥20 mm were assigned 1 point each, while age ≥75 years,
female gender, lesion location in the right coronary artery, blunt
stump, and bending >45° were assigned 2 points each. For each
predictor, the points assigned were based on the associated odds ratio
by multivariate analysis. The lesions were classified into 4 groups
according to the summation of points scored to assess the probability of
successful CTO recanalization: easy (score 0-1), intermediate (score
2-3), difficult (score 4-5), and very difficult (score ≥6). CTO opening
was designated as the primary endpoint regardless of the interventional
era or the skill of the operator. <b><i>Results:</i></b> The final
success rate for B-CTO was 81.1%. The probability of successful
recanalization for patient groups classified as easy (<i>n</i> = 64), intermediate (<i>n</i> = 148), difficult (<i>n</i> = 134), and very difficult (<i>n</i> = 92) was 95.3, 86.5, 79.1 and 65.2%, respectively (<i>p</i>
for trend <0.001). When compared to the J-CTO, the B-CTO score
demonstrated a significant improvement in discrimination as indicated by
the area under the receiver-operator characteristic curve (AUC 0.083;
95% CI 0.025-0.141), with a positive integrated discrimination
improvement of 0.042 and a net reclassification improvement of 56.0%. <b><i>Conclusions:</i></b>
The B-CTO score has been designed and validated in Korean patients with
native coronary CTO and is an improved tool for predicting successful
recanalization. Wider application of the B-CTO score remains to be
explored.</p>
2017-02-07 14:23:56
Predictors
Chronic total occlusion
Recanalization
Registry
Korean patients