Choice of CTO scores to predict procedural success in clinical practice. A comparison of 4 different CTO PCI scores in a comprehensive national registry including expert and learning CTO operators

• DOI: 10.1371/journal.pone.0245898
• Publication Date: 2021-04-02T17:27:41Z
• Authors: Pablo Salinas; Nieves Gonzalo; Víctor H. Moreno; Manuel Fuentes; Sandra Santos-Mar...; José Antonio Fern...; Ignacio J. Amat-S...; Francisco Bosa Ojeda; Juan Caballero Bo...; Javier Cuesta; José María de la ...; Alejandro Diego-N...; Daniela Dubois; Guillermo Galeote; Javier Goicolea; Alejandro Gutiérrez; Miriam Jiménez-Fe...; Jesús Jiménez-Maz...; Alfonso Jurado; Javier Lacunza; Dae-Hyun Lee; María López; Fernando Lozano; Javier Martin-Mor...; Victoria Martin-Y...; Raúl Millán; Gema Miñana; Mohsen Mohandes; Francisco J. Mora...; Julio Núñez; Soledad Ojeda; Manuel Pan; Fernando Rivero; Javier Robles; Sergio Rodríguez-...; Sergio Rojas; Juan Rondán; Eva Rumiz; Manel Sabaté; Juan Sanchís; Beatriz Vaquerizo; Javier Escaned
• Keywords: Male; Science; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Health Status Indicators::Patient Acuity::Severity of Illness Index; Risk Assessment; Severity of Illness Index; Medical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Coronary Disease::Coronary Occlusion; Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans; 03 medical and health sciences; Percutaneous Coronary Intervention; 0302 clinical medicine; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Area Under Curve; Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged; Humans; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis; Aged; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome; Q; R; Medical Subject Headings::Check Tags::Female; Middle Aged; Prognosis; Medical Subject Headings::Check Tags::Male; Treatment Outcome; Coronary Occlusion; Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged; Area Under Curve; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Calibration; Medicine; Female; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Registries; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Endovascular Procedures::Percutaneous Coronary Intervention; Research Article

We aimed to compare the performance of recent CASTLE score J-CTO, CL and PROGRESS CTO scores in a comprehensive database percutaneous coronary intervention chronic total occlusion procedures.Scores were calculated using raw data from 1,342 procedures included REBECO Registry that includes learning expert operators. Calibration, discrimination reclassification evaluated compared.Mean values were: 1.60±1.10, J-CTO 2.15±1.24, 1.68±0.94 2.52±1.52 points. The overall success rate was 77.8%. Calibration good for CL, but not or scores. Discrimination: area under curve (AUC) (0.633) significantly higher than (0.557) similar (0.628) (0.652). Reclassification: CASTLE, as assessed by integrated improvement, superior (integrated improvement +0.036, p<0.001), slightly inferior (- 0.011, p = 0.004). Regarding net reclassified better (overall continuous 0.379, p<0.001) roughly 20% cases.Procedural difficulty is consistently depicted available influenced characteristics each cohort. In our study population, including operators, had along with score. However, we found only intermediate c-statistic predicting among all