The EuroCTO (CASTLE) score had equal overall discriminatory capacity to the J-CTO score for predicting CTO PCI success (AUC difference 0.022, p=0.5), but was superior for complex cases.
Observational (n=660)
Does the EuroCTO (CASTLE) score improve the prediction of procedural success in CTO PCI compared to the J-CTO score?
The novel EuroCTO (CASTLE) score is comparable to the J-CTO score for predicting CTO PCI success overall, but offers superior discriminatory capacity for more complex cases.
Effect estimate: AUC difference 0.022
Absolute Event Rate: 0.676% vs 0.698%
p-value: p=0.5
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 coronary intervention (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 operating 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 or EuroCTO CASTLE ≥4]), the predictive capacity of the 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.
Kalogeropoulos et al. (Wed,) conducted a observational in coronary chronic total occlusions (CTOs) (n=660). EuroCTO (CASTLE) score vs. J-CTO score was evaluated on procedural success of percutaneous coronary intervention (AUC difference 0.022, p=0.5). The EuroCTO (CASTLE) score had equal overall discriminatory capacity to the J-CTO score for predicting CTO PCI success (AUC difference 0.022, p=0.5), but was superior for complex cases.