Comparison of the novel EuroCTO (CASTLE) score with the J-CTO score for predicting technical success of coronary chronic total occlusions percutaneous revascularization

Kalogeropoulos, Andreas S. and Alsanjari, Osama and Keeble, Thomas R. and Tang, Kare H. and Konstantinou, Klio and Katsikis, Athanasios and Jagathesan, Rohan and Aggarwal, Rajesh K. and Clesham, Gerald J. and Kelly, Paul A. and Werner, Gerald S. and Hildick-Smith, David and Davies, John R. and Karamasis, Grigoris V. (2019) Comparison of the novel EuroCTO (CASTLE) score with the J-CTO score for predicting technical success of coronary chronic total occlusions percutaneous revascularization. EuroIntervention. ISSN 1969-6213 (Accepted)

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Official URL: http://dx.doi.org/10.4244/EIJ-D-19-00352

Abstract

Aims: We sought to compare the efficiency of the novel EuroCTO (CASTLE) score with the commonly used Multicentre CTO registry in Japan (J-CTO) score in predicting procedural success of percutaneous recanalization (PCI) for coronary chronic total occlusions (CTOs). Methods and results: We evaluated 660 consecutive CTO PCIs (mean age: 66±11 years, 84% male). The mean J-CTO and EuroCTO (CASTLE) scores were 1.86 ± 1.2 and 1.74 ± 1.2, respectively. Antegrade wire escalation, antegrade dissection re-entry and retrograde approach were used in 82%, 14% and 37% of cases, respectively. Receiver-operator characteristic analysis demonstrated equal overall discriminatory capacity between the two scores (AUC: 0.698, 95%CI: 0.653-0.742 p<0.001 for J-CTO vs. AUC: 0.676, 95%: CI 0.627-0.725, p<0.001 for EuroCTO; AUC difference: 0.022, p=0.5). However, for more complex procedures [(J-CTO ³ 3 or EuroCTO (CASTLE) ³ 4)], the predictive capacity of EuroCTO (CASTLE) score appeared superior (AUC: 0.588, 95% CI 0.509-0.668, p=0.03 for EuroCTO (CASTLE) score vs. AUC: 0.473, 95% CI 0.393-0.553, p=NS for the J-CTO score, AUC difference: 0.115, p=0.04) Conclusions: In this study, the novel EuroCTO (CASTLE) score was comparable to the J-CTO score in predicting CTO PCI outcome with a superior discriminatory capacity for the more complex cases.

Item Type: Journal Article
Keywords: Chronic total occlusion, stable angina, multiple vessel disease
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 29 Jul 2019 11:26
Last Modified: 03 Sep 2019 14:12
URI: http://arro.anglia.ac.uk/id/eprint/704599

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