Evaluation of in-stent restenosis (ISR) by computed tomography coronary angiography (CTCA) is less invasive but often impossible. We aimed to create a scoring model for predicting which drug-eluting stents (DES) cannot be evaluated with CTCA. We enrolled 757 consecutive implanted DES assessed with CTCA. Non-diagnostic evaluation was defined as poor/not evaluative by two different observers. These stents were randomly divided into a derivation (n = 379) and validation (n = 378) group. In the derivation group, we assessed predictors using logistic regression analysis and created a scoring model that would stratify non-diagnostic evaluation of DES-ISR. The validity of this scoring model was evaluated in the validation group using receiver-operating characteristic analysis. The percentage of non-diagnostic stents was 19/21% in the derivation/validation group (p = 0.71). Non-diagnostic evaluation was independently associated with implanted stent diameter (2.25–2.5. vs. 2.5–3 vs. > 3.0 mm), severe calcification, stent-in-stent lesion, and type of DES (stainless vs. CoCr vs. PtCr) in the derivation group. The predicting system of implanted DES non-diagnostic by CTCA (PIDENT) for non-diagnostic evaluation, including these four baseline factors, was derived (C-statistic = 0.86 in derivation group, cutoff: 8 points). The PIDENT score had a high predictive value for non-diagnostic DES in the validation model (C-statistic = 0.87, sensitivity 86%, specificity 74%, cutoff 8 points, p < 0.001). The PIDENT score, consisting of baseline characteristics including implanted stent diameter, severe calcification, stent-in-stent lesion, and type of DES, could identify non-diagnostic evaluation of DES-ISR with CTCA. The PIDENT score was valuable in reducing nonevaluable and meaningless CTCA for DES-ISR.

通过计算机断层扫描冠状动脉造影 (CTCA) 评估支架内再狭窄 (ISR) 的侵入性较小，但通常是不可能的。我们旨在创建一个评分模型，用于预测哪些药物洗脱支架 (DES) 不能使用 CTCA 进行评估。我们招募了 757 例用 CTCA 评估的连续植入 DES。两个不同的观察者将非诊断性评估定义为差/不评估。这些支架被随机分为推导（n  = 379）和验证（n = 378) 组。在推导组中，我们使用逻辑回归分析评估预测因子，并创建了一个评分模型，对 DES-ISR 的非诊断性评估进行分层。该评分模型的有效性在验证组中使用接受者操作特征分析进行评估。衍生/验证组中非诊断支架的百分比为 19/21% ( p = 0.71)。非诊断性评估与植入支架直径（2.25-2.5. vs. 2.5-3 vs. > 3.0 mm）、严重钙化、支架内支架损伤和 DES 类型（不锈钢 vs. CoCr vs. PtCr ) 在派生组中。推导了CTCA（PIDENT）植入DES非诊断性评估的预测系统，包括这四个基线因素（推导组的C-statistic = 0.86，截止：8分）。PIDENT 评分对验证模型中的非诊断性 DES 具有高预测值（C 统计量 = 0.87，敏感性 86%，特异性 74%，截止 8 分，p < 0.001)。PIDENT 评分由基线特征组成，包括植入支架直径、严重钙化、支架内病变和 DES 类型，可以识别 CTCA 对 DES-ISR 的非诊断性评估。PIDENT 评分对于减少 DES-ISR 的无价值和无意义的 CTCA 很有价值。