Abstract
To evaluate the incremental interest of performing a calcium score before CTO procedures, compared to the angiographic J-CTO score alone. Prospective cohort of 109 consecutive patients with 119 de novo CTO lesions. Angiographic grading with the J-CTO score was compared with CT + angiographic staging (calcium score cut off>400) and a “corrected” J-CTO score, by ROC curve analysis to predict a successful recanalization. Thirty-two lesions (27%) had a calcium score >400.13 (11%) patients were reclassified in the “corrected” J-CTO score because calcifications were not seen in the angiogram. The factors significantly associated with the failure of the procedure were J-CTO score (OR 0.486 [0.32-0.73], p<0.001), corrected J-CTO score (OR 0.494 [0.33-0.73], p<0.001), a blunt lesion (OR 0399 [0182-0871], p=0.021) and a second attempt (OR 0322 [0121-0856], p=0.110). The calcium score >400 was not found associated with the failure of the procedure (OR 0.545 [0239-1243], p<0.149). By multivariate analysis, both J-CTO score (OR 0.645 [0418-0995], p=0.047) and the corrected J-CTO score (OR 0.631 (0410-0972] were significantly associated with a successful recanalization. However, calibration of the corrected J-CTO score was less good than the angiographic J-CTO score alone. This study suggested that calcium score evaluation before CTO procedures is not useful for grading PCI difficulty. Abstract 0489 – Figure: ROC curves analysis to predict success of the CTO
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