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.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/ccd.28104 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Postprocedural Contrast-Associated Acute Kidney Injury and Prognosis of Patients Undergoing Recanalization of Chronic Total Occlusions.
J Clin Med
December 2024
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria.
Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) requires advanced techniques and prolonged procedural efforts, often necessitating high contrast volumes, which may increase the risk of contrast-associated acute kidney injury (CA-AKI). However, evidence suggests that factors beyond contrast exposure contribute to CA-AKI, though data specific to CTO PCI remain limited. Patients undergoing contemporary CTO PCI at our university-affiliated tertiary care center were enrolled.
View Article and Find Full Text PDFRandomized comparison of a Gladius first versus standard antegrade wiring strategy for crossing coronary chronic total occlusions: the Gladius first trial.
J Invasive Cardiol
December 2024
Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland.
Objectives: Antegrade wiring (AW) is the most common coronary chronic total occlusion (CTO) crossing strategy and usually relies upon stepwise guidewire escalation starting from the low tip-load polymer-jacketed wire (standard guidewire escalation). The authors aimed to investigate whether the upfront use of intermediate tip-load polymer-jacketed guidewire translates into improved procedural outcomes of CTO percutaneous coronary intervention (PCI).
Methods: The Gladius First trial was a single-center, investigator-initiated, randomized, prospective trial.
Successful Percutaneous Coronary Intervention for Chronic Total Occlusion in Left Ventricular Systolic Dysfunction Patients with and without Diabetes Mellitus.
Rev Cardiovasc Med
November 2024
Department of Cardiology, Xiangtan Central Hospital, 411100 Xiangtan, Hunan, China.
Article Synopsis
- The study examines the outcomes of patients with left ventricular (LV) systolic dysfunction who underwent successful PCI for chronic total occlusion (CTO), focusing on those with and without diabetes mellitus (DM) over two years.
- Among 185 patients, 53.5% had DM, which was linked to worse kidney function, more complex heart disease, and significantly higher rates of major adverse cardiovascular events (MACEs) and mortality.
- Despite the increased risks associated with DM, multivariable analysis indicated that DM itself was not a strong independent predictor of MACEs, while factors like multi-vessel disease and chronic kidney disease were significant predictors of adverse outcomes.
Outcomes of Left Main Chronic Total Occlusion Percutaneous Coronary Interventions.
Catheter Cardiovasc Interv
January 2025
Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
Article Synopsis
- The study looked at the outcomes of patients undergoing percutaneous coronary intervention (PCI) for left main (LM) chronic total occlusions (CTO) compared to non-LM CTOs across multiple centers from 2012 to 2024.
- Out of over 15,000 CTO PCIs, only 85 involved LM CTOs, which were associated with older patients who commonly had higher rates of health issues like heart failure and previous bypass surgeries.
- Despite higher complications and angiographic complexity in LM CTO cases, the technical success rates were similar to non-LM PCIs, indicating that they can be performed safely despite their challenges.
Validation of the coronary artery specific chronic total occlusion percutaneous coronary intervention angiographic difficulty scores in the PROGRESS-CTO registry.
Cardiovasc Revasc Med
October 2024
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA. Electronic address:
Background: The J-CTO investigators recently developed angiographic difficulty scores for each of the three major coronary arteries in patients undergoing first-attempt chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in de novo occlusions.
Methods: We examined the performance of the individual J-CTO scores in a large multicenter registry.
Results: The CTO lesion location was as follows: right coronary artery (RCA) 3,805 (54%), left anterior descending artery (LAD) 2,303 (33%), and left circumflex (LCX) 935 (13%).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!