Scoring System for Identification of “Survival Advantage” after Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Definitions
2.3. Outcomes
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Development of a Scoring System
3.3. Depressed Left Ventricular (LV) Function and Involvement of the LAD
3.4. Performance of HABARA Score and J-CTO Score to be Used in Place of Each Other
3.5. Prediction of the Influence of the Results of CTO-PCI on the MACCE Rate
4. Discussion
4.1. Utility of the HABARA Score
4.2. Score Components
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Successful CTO-PCI | Failed CTO-PCI | P Value | |
---|---|---|---|
(n = 2330) | (n = 295) | ||
Clinical characteristics | |||
Age, years | 68 ± 10 | 69 ± 10 | 0.22 |
Male | 1950 (84%) | 241 (82%) | 0.32 |
Prior MI | 861 (38%) | 112 (39%) | 0.79 |
Prior CABG | 179 (8%) | 44 (15%) | <0.001 |
Hypertension | 1806 (78%) | 246 (84%) | 0.026 |
Diabetes mellitus | 1014 (44%) | 128 (44%) | 0.93 |
Hyperlipidemia | 1639 (71%) | 204 (70%) | 0.76 |
Smoker | 1177 (54%) | 134 (48%) | 0.09 |
Peripheral vascular disease | 273 (13%) | 41 (15%) | 0.27 |
Hemodialysis | 114 (5%) | 33 (12%) | <0.001 |
CCS 0 | 755 (34%) | 96 (33%) | 0.61 |
CCS I | 630 (28%) | 92 (32%) | |
CCS II | 656 (29%) | 82 (28%) | |
CCS III | 144 (6%) | 14 (5%) | |
CCS IV | 51 (2%) | 5 (2%) | |
Cr, mg/dL | 1.4 ± 2.2 | 1.8 ± 2.6 | 0.001 |
eGFR, mL/min/1.73 m2 | 61.9 ± 22.7 | 59.5 ± 49.3 | 0.153 |
LVEF | |||
<35% | 176 (8%) | 29 (10%) | 0.32 |
35%–50% | 513 (23%) | 70 (25%) | |
>50% | 1523 (69%) | 185 (65%) | |
Cerebrovascular disease | 92 (4%) | 17 (6%) | 0.14 |
Angiographic characteristics | |||
Multivessel disease | 1376 (60%) | 192 (66%) | 0.07 |
CTO vessel | |||
Right | 1073 (46%) | 159 (54%) | 0.012 |
Left anterior descending | 745 (32%) | 67 (23%) | |
Left circumferential | 497 (21%) | 68 (23%) | |
Left main trunk | 8 (0.3%) | 1 (0.3%) | |
In-stent occlusion | 360 (16%) | 35 (12%) | 0.102 |
Blunt stump | 1222 (53%) | 185 (64%) | 0.001 |
Lesion calcification | 1843 (80%) | 239 (83%) | 0.242 |
Lesion bending | 174 (8%) | 46 (10%) | <0.001 |
Occlusion length ≥20 mm | 988 (51%) | 136 (62%) | 0.003 |
Reattempted lesion | 200 (9%) | 54 (19%) | <0.001 |
Collateral channel classification | |||
CC0 | 123 (6%) | 14 (6%) | 0.54 |
CC1 | 1243 (64%) | 161 (68%) | |
CC2 | 575 (30%) | 63 (27%) | |
J-CTO score | 1.90±0.99 | 2.24±1.06 | <0.001 |
Procedural characteristics | |||
Air kerma, mGy | 4534 ± 4408 | 6175 ± 4661 | <0.001 |
Procedural time, min | 149 ± 86 | 196 ± 94 | <0.001 |
Fluoroscopy time, min | 66 ± 45 | 96 ± 52 | <0.001 |
Contrast dose, mL | 214 ± 99 | 237 ± 119 | <0.001 |
Retrograde procedure | 664 (29%) | 149 (51%) | <0.001 |
Periprocedural complications | |||
Periprocedural MI | 0 (0%) | 10 (3%) | <0.001 |
Symptomatic cerebrovascular disease | 0 (0%) | 4 (1.4%) | <0.001 |
Coronary perforation | 51 (2.2%) | 23 (7.9%) | <0.001 |
Access site bleeding | 8 (0.3%) | 5 (1.7%) | 0.002 |
Heart failure | 0 (0%) | 0 (0%) | - |
Emergency CABG | 0 (0%) | 0 (0%) | - |
Emergency TVR | 0 (0%) | 0 (0%) |
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Nakachi, T.; Kohsaka, S.; Yamane, M.; Muramatsu, T.; Okamura, A.; Kashima, Y.; Matsuno, S.; Sakurada, M.; Seino, Y.; Habara, M. Scoring System for Identification of “Survival Advantage” after Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion. J. Clin. Med. 2020, 9, 1319. https://doi.org/10.3390/jcm9051319
Nakachi T, Kohsaka S, Yamane M, Muramatsu T, Okamura A, Kashima Y, Matsuno S, Sakurada M, Seino Y, Habara M. Scoring System for Identification of “Survival Advantage” after Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion. Journal of Clinical Medicine. 2020; 9(5):1319. https://doi.org/10.3390/jcm9051319
Chicago/Turabian StyleNakachi, Tatsuya, Shun Kohsaka, Masahisa Yamane, Toshiya Muramatsu, Atsunori Okamura, Yoshifumi Kashima, Shunsuke Matsuno, Masami Sakurada, Yoshitane Seino, and Maoto Habara. 2020. "Scoring System for Identification of “Survival Advantage” after Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion" Journal of Clinical Medicine 9, no. 5: 1319. https://doi.org/10.3390/jcm9051319