Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion
Abstract Background This study sought to develop and externally validate a score that predicts the probability for poor coronary collateralization (CC) in stable angina patients with type 2 diabetes mellitus (T2DM). Methods Clinical and laboratory variables were collected on admission in 1022 T2DM p...
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BMC
2025-04-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04687-8 |
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| author | Lin Shuang Mao Liang Geng Yi Xuan Wang Yang Qi Min Hui Wang Feng Hua Ding Yang Dai Lin Lu Qi Zhang Wei Feng Shen Ying Shen |
| author_facet | Lin Shuang Mao Liang Geng Yi Xuan Wang Yang Qi Min Hui Wang Feng Hua Ding Yang Dai Lin Lu Qi Zhang Wei Feng Shen Ying Shen |
| author_sort | Lin Shuang Mao |
| collection | DOAJ |
| description | Abstract Background This study sought to develop and externally validate a score that predicts the probability for poor coronary collateralization (CC) in stable angina patients with type 2 diabetes mellitus (T2DM). Methods Clinical and laboratory variables were collected on admission in 1022 T2DM patients with chronic total occlusion (CTO). Coronary collaterals with Rentrop score 0 or 1 were considered as poor CC. Multivariable logistic regression analysis was used to identify independent predictors for poor CC. The external validation cohort comprised 234 T2DM patients with CTO selected randomly from an independent external center. Results Eight predictors were independently associated with poor CC and applied to construct the risk model. A score incorporating these factors predicted poor CC, ranging from 7% when all factors were absent to 97% when ≥ 7 factors were present. Internal validation showed an AUC of 0.748 (95%CI, 0.695–0.795) and the external validation had an AUC of 0.754 (95%CI, 0.694–0.808). A cumulative predictive score was developed by summing points assigned to each factor based on its regression coefficient. Smoking and neutrophil > 6.5 × 10⁹/L were assigned 3 points, female gender, hypercholesterolemia, and eGFR < 60 mL/min/1.73 m² were assigned 2 points, age > 65 years, hypertension, and HbA1c > 6.5% were assigned 1 point. The optimal cutoff score was 4 for predicting poor CC with sensitivity 75.4% and specificity 64.1%. Conclusions We have demonstrated a risk score based on clinical and laboratory characteristics providing an easy-to-use tool to predict poor CC in T2DM patients with stable coronary artery disease. Clinical trial number NCT06054126 Date of registration: September 19th, 2023. |
| format | Article |
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| institution | DOAJ |
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| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-71d3a6ec488d466fab18b5d232bfe8fa2025-08-20T03:08:02ZengBMCBMC Cardiovascular Disorders1471-22612025-04-0125111010.1186/s12872-025-04687-8Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusionLin Shuang Mao0Liang Geng1Yi Xuan Wang2Yang Qi3Min Hui Wang4Feng Hua Ding5Yang Dai6Lin Lu7Qi Zhang8Wei Feng Shen9Ying Shen10Department of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, Shanghai Eastern Hospital, Tongji University School of MedicineDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, Shanghai Eastern Hospital, Tongji University School of MedicineDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityDepartment of Cardiovascular Medicine, School of Medicine, Rui Jin Hospital, Shanghai Jiao Tong UniversityAbstract Background This study sought to develop and externally validate a score that predicts the probability for poor coronary collateralization (CC) in stable angina patients with type 2 diabetes mellitus (T2DM). Methods Clinical and laboratory variables were collected on admission in 1022 T2DM patients with chronic total occlusion (CTO). Coronary collaterals with Rentrop score 0 or 1 were considered as poor CC. Multivariable logistic regression analysis was used to identify independent predictors for poor CC. The external validation cohort comprised 234 T2DM patients with CTO selected randomly from an independent external center. Results Eight predictors were independently associated with poor CC and applied to construct the risk model. A score incorporating these factors predicted poor CC, ranging from 7% when all factors were absent to 97% when ≥ 7 factors were present. Internal validation showed an AUC of 0.748 (95%CI, 0.695–0.795) and the external validation had an AUC of 0.754 (95%CI, 0.694–0.808). A cumulative predictive score was developed by summing points assigned to each factor based on its regression coefficient. Smoking and neutrophil > 6.5 × 10⁹/L were assigned 3 points, female gender, hypercholesterolemia, and eGFR < 60 mL/min/1.73 m² were assigned 2 points, age > 65 years, hypertension, and HbA1c > 6.5% were assigned 1 point. The optimal cutoff score was 4 for predicting poor CC with sensitivity 75.4% and specificity 64.1%. Conclusions We have demonstrated a risk score based on clinical and laboratory characteristics providing an easy-to-use tool to predict poor CC in T2DM patients with stable coronary artery disease. Clinical trial number NCT06054126 Date of registration: September 19th, 2023.https://doi.org/10.1186/s12872-025-04687-8Coronary artery diseaseChronic total occlusionCoronary collateral circulationType 2 diabetes mellitusRisk score |
| spellingShingle | Lin Shuang Mao Liang Geng Yi Xuan Wang Yang Qi Min Hui Wang Feng Hua Ding Yang Dai Lin Lu Qi Zhang Wei Feng Shen Ying Shen Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion BMC Cardiovascular Disorders Coronary artery disease Chronic total occlusion Coronary collateral circulation Type 2 diabetes mellitus Risk score |
| title | Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion |
| title_full | Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion |
| title_fullStr | Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion |
| title_full_unstemmed | Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion |
| title_short | Clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion |
| title_sort | clinical risk score to predict poor coronary collateralization in type 2 diabetic patients with chronic total occlusion |
| topic | Coronary artery disease Chronic total occlusion Coronary collateral circulation Type 2 diabetes mellitus Risk score |
| url | https://doi.org/10.1186/s12872-025-04687-8 |
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