Association between J-CTO score and long-term target lesion revascularization rate after successful chronic total coronary occlusion angioplasty (from the J-CTO Registry)

Abstract

Objectives: The aim of this study was to evaluate the impact of the J-CTO score on long-term target lesion revascularization (TLR) after successful native chronic total occlusion (CTO)-percutaneous coronary intervention (PCI).

Background: We previously reported that the J-CTO score could be used to stratify the lesion complexity and procedural success rate in CTO lesions.

Methods: We evaluated the prognostic significance of a high J-CTO score for long-term TLR rate in the J-CTO Registry.

Results: In the 425 lesions of 408 patients who underwent successful CTO-PCI during a median follow-up of 63.0 (interquartile range: 21.2-72.9) months in the J-CTO Registry, the cumulative incidence of TLR of lesions with a J-CTO score ≥ 2 (n = 216) was significantly higher than in those with a J-CTO score ≤ 1 (n = 209) (27.0 versus 19.4% at 5 years, respectively, P = 0.04). Among 323 lesions of 309 patients with a complete 5-year follow-up, the rate of TLR was 28% (n = 91). A J-CTO score ≥ 2 was independently associated with a higher risk of TLR (odds ratio, 1.73; 95% confidence interval, 1.01-2.99, P = 0.048) even after adjustment for clinically relevant baseline factors.

Conclusions: Patients with high J-CTO score lesions had a higher 5-year risk of TLR.

Keywords: chronic total occlusion; percutaneous coronary intervention; target lesion revascularization.