Author + information
- John Thomas Saxona,b,
- Adam Salisburya,b,
- James Granthama,b,
- James Sapontisa,b,
- William Lombardia,b,
- Dimitrios Karmpaliotisa,b,
- Jeffrey Mosesa,b,
- Yuanyuan Tanga,b,
- David Cohena,b,
- John Spertusa,b and
- David Safleya,b
Background: The ACC/AHA Appropriate Use Criteria (AUC) were designed to aid clinical decision-making, yet their association with health status outcomes after CTO PCI is unknown.
Methods: We enrolled 1,000 patients undergoing CTO PCI in the 12-center OPEN CTO registry. 52 patients were excluded due to incomplete data or multi vessel CTO. AUC indication was determined by computer-based algorithm using clinical data and symptom status (CCS class) as assessed by the operator. We examined the relationship between AUC status and 1-year health status as determined by the Seattle Angina Questionnaire Angina Frequency (SAQ AF) and Summary (SAQ Summ) scores. We also examined the proportion of patients who experienced a small (10 point), medium (20 point), and large (30 point) improvement in scores.
Results: The AUC indication was appropriate in 507 (53%), uncertain in 226 (24%), and rarely appropriate in 14 (1%). An additional 201 (21%) patients were unmappable due to absence of stress testing. The appropriate group had the greatest improvement in mean scores at 1 year (Figure 1a) and the highest proportion of responders at each threshold (Figure 1b).
Conclusions: For CTO PCI, an AUC designation of appropriate was associated with greater health status improvement at 1 year compared with other AUC groups. However, a substantial proportion of patients in the uncertain and rarely appropriate groups experienced significant health status benefit, suggesting that lower AUC class should not preclude CTO PCI in selected patients.
Moderated Poster Contributions
Interventional Cardiology Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 11:30 a.m.-11:40 a.m.
Session Title: Refining PCI Technique and Outcomes
Abstract Category: 20. Interventional Cardiology: Coronary Intervention: CTO
Presentation Number: 1135M-15
- 2017 American College of Cardiology Foundation