ECG-derived DETERMINE score can provide information about procedure success in chronic total occlusion patients

Area of Science:

• Cardiology
• Interventional Cardiology
• Diagnostic Electrocardiography

Background:

• Chronic total occlusion (CTO) interventions aim to improve patient outcomes, but procedural success is variable.
• Predicting success is crucial for patient selection and optimizing treatment strategies.
• Existing scoring systems are used to assess factors influencing CTO intervention outcomes.

Purpose of the Study:

• To evaluate the association between the electrocardiography (ECG)-derived DETERMINE score and the procedural success of chronic total occlusion (CTO) interventions.
• To determine if the DETERMINE score can serve as an independent predictor of CTO intervention outcomes.

Main Methods:

• A study involving 301 patients undergoing CTO interventions.
• Patients were categorized into successful (69%) and unsuccessful (31%) revascularization groups.
• Analysis included assessment of clinical factors, coronary collateral status, and ECG parameters, including the DETERMINE score.

Main Results:

• The unsuccessful revascularization group exhibited higher DETERMINE scores, lower left ventricular ejection fraction (LVEF), and higher j-CTO scores.
• Multivariate logistic regression identified LVEF, j-CTO score, absence of good coronary collateral, and DETERMINE score as independent predictors of unsuccessful revascularization.
• Patients with unsuccessful interventions had longer QRS and QT/QTc intervals.

Conclusions:

• The DETERMINE score, a novel ECG-based tool, shows potential in predicting procedural success in CTO interventions.
• Incorporating the DETERMINE score into clinical assessment may assist in patient selection and decision-making for CTO procedures.
• ECG findings, including those captured by the DETERMINE score, offer valuable insights into CTO intervention outcomes.