Predictive value of chronic total occlusion score based on coronary CT angiography in interventional treatment of chronic total occlusion of coronary artery
10.3760/cma.j.issn.1005-1201.2020.01.004
- VernacularTitle: 基于冠状动脉CT血管成像的慢性完全闭塞病变评分在介入治疗中的预测价值
- Author:
Lei YIN
1
;
Binbin TENG
2
;
Mingping MA
1
;
Yang LIN
3
;
Bing CHEN
3
Author Information
1. Department of Radiology, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou 350001, China
2. Department of Radiology, Fuzhou No.2 Hospital, Fuzhou 350001, China
3. Siemens Healthineers Ltd, Shanghai 201318, China
- Publication Type:Journal Article
- Keywords:
Coronary occlusion;
Tomography, X-ray computed
- From:
Chinese Journal of Radiology
2020;54(1):17-22
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of modified chronic total occlusion (CTO) scores based on coronary computed tomography angiography (CCTA) for the outcome of CTO lesions after percutaneous coronary intervention (PCI).
Methods:A total of sixty-six patients who had undergone CCTA examinations were retrospectively enrolled and divided into PCI-success group (n=48) and PCI-failure group (n=18). Age, body mass index (BMI), calcium score (CACS), location and extent of CTO occlusive segments were recorded and compared between the two groups using paired-samples t test. In addition, the differences of gender, hypertension, hyperlipidemia, hyperuricemia, diabetes mellitus, myocardial infarction and angina pectoris were analyzed by using chi-square test and Fisher exact test. J-CTO score based on CCTA images (J-CTOCT) was calculated. Furthermore, modified-CTO score (m-CTOCT) was measured by redefining the calcification degree (mild, severe) and range (full segment, part) in the J-CTO scoring system. Predictive value of J-CTOCT and m-CTOCT on recanalization success was evaluated by the receiver operating curve (ROC) analysis.
Results:There were no significant differences in patients′ clinical indices between the two groups (all P>0.05). Compared to PCI-success group, blunt cap, blending>45 degrees, lesion length>20 mm, full calcification segment of lesion (χ2=5.012, 3.999 and 4.103, respectively; P<0.05) occurred more frequently in the PCI-failure group. In addition, the incidence of occlusive calcification was significantly increased in the PCI-failure group (P<0.05), as well as the total occlusive calcification (P=0.001) and severe occlusive calcification (P=0.000). Nevertheless, the rate of mild occlusive calcification was significantly higher in the PCI-success group (P=0.037). There were no significant differences in calcification location, calcification score and extent of calcification (P>0.05) between the two groups. The area under ROC (AUC) of m-CTOCT (0.921) was significantly higher than that of J-CTOCT (0.847, P<0.001).
Conclusions:Morphological evaluation of CCTA is helpful to predict the surgical success in patients with PCI. m-CTOCT scoring shows higher predictive value compared to traditional J-CTOCT score.
