Author + information
- Mohammed Qintar1,
- Taishi Hirai2,
- Christian Patterson3,
- James Sapontis4,
- J. Aaron Grantham1,
- Kensey Gosch5,
- Philip Jones6,
- Yuanyuan Tang7,
- John Spertus5,
- Suzanne Arnold8 and
- Adam Salisbury5
- 1University of Missouri Kansas City and Mid America Heart Institute, Kansas City, Missouri, United States
- 2University of Chicago Medical Center, Chicago, Illinois, United States
- 3Saint Luke's Health System, Overland Park, Kansas, United States
- 4MonashHeart, Victoria, Victoria, Australia
- 5Mid America Heart Institute, Kansas City, Missouri, United States
- 6St. Luke's Hospital, Mid-America Heart Institute, Kansas City, Missouri, United States
- 7Saint Luke's Health System, Kansas City, Missouri, United States
- 8Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
Relief of angina is often the primary goal of CTO PCI; however, recurrent or residual angina is reported ∼20% of patients. Understanding which patients are at high risk for residual angina after CTO PCI can help guide management after PCI, but no model currently exists to estimate individual patients’ risk of angina in this unique population of patients.
We examined the performance of a previously published model to estimate risk of residual angina at 6 months after PCI (developed in a general PCI cohort) among patients undergoing CTO PCI. The original model included 8 variables (age, financial status, depression, # of antianginal medications at baseline, disease presentation [NSTEMI, UA, stable angina], self-reported pain, and baseline angina and quality of life [from the Seattle Angina Questionnaire]). We examined discrimination and calibration of the model in the 12 US-center OPEN CTO registry.
Among 797 patients who underwent CTO PCI (technical success 86%), 189 (24%) reported angina at 6-month follow-up. The model demonstrated excellent discrimination (c=0.75) and calibration (Figure).
A previously published model to estimate risk of residual angina at 6-months after general PCI also performed well in patients undergoing CTO PCI. This model may allow for more personalized treatment with CTO PCI by identifying patients who may benefit more from complete revascularization, slower de-escalation of antianginal medications, non-pharmacologic treatments of angina (e.g., EECP), or simply closer follow-up after CTO PCI.
CORONARY: PCI Outcomes