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

Abstract

Background: Successful chronic total occlusion (CTO) interventions may provide symptomatic relief, improve left ventricular ejection fraction (LVEF), and improve clinical outcomes. In contrast, unsuccessful interventions may increase major adverse cardiovascular event rates. Several studies have investigated various scoring systems used to predict procedural success. The DETERMINE score is an electrocardiography (ECG) score that includes Q waves, fragmented QRS, and T wave inversions. This study aimed to investigate the relationship between the procedural success of CTO and the ECG-derived DETERMINE score system.

Methods: Our study included 301 patients. The patients were divided into successful revascularization (69 %) and unsuccessful revascularization (31 %).

Results: The unsuccessful revascularization group had a higher history of coronary artery disease, lower glomerular filtration rate (GFR) levels, lower left LVEF, higher j-CTO score, less good coronary collateral, higher retrograde approach, longer QRS interval, longer QT and QTc interval, and higher DETERMINE score than the successful revascularization group. The multivariate logistic regression test results indicated LVEF, j-CTO score, absence of good coronary collateral, and DETERMINE score as independent predictive parameters for unsuccessful revascularization.

Conclusion: Predicting procedural success in CTO patients is crucial, especially when selecting patients. The DETERMINE score, obtained from the ECG, may aid in decision-making.

Keywords: Chronic total occlusion; Electrocardiography; Procedural success; Score.