Mitsuru Abe1, Takeshi Morimoto2, Yoshihiro Morino3, Hiroyuki Tanaka4, Masaharu Akao1, Yasuhiko Hayashi5, Toshiya Muramatsu6, Masahiko Ochiai7, Yuichi Noguchi8, Kazuhiko Yumoto9, Yoshisato Shibata10, Yoshikazu Hiasa11, Osamu Doi12, Takehiro Yamashita13, Tomoaki Hinohara14, Kazushige Kadota4, Takeshi Kimura15. 1. Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 2. Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan. 3. Division of Cardiology, Iwate Medical University, Morioka, Japan. 4. Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan. 5. Division of Cardiology, Tsuchiya General Hospital, Hiroshima, Japan. 6. Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan. 7. Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, Yokohama, Japan. 8. Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan. 9. Department of Cardiovascular Medicine, Yokohama Rosai Hospital, Yokohama, Japan. 10. Cardiovascular Center, Miyazaki Medical Association Hospital, Miyazaki, Japan. 11. Department of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan. 12. Division of Cardiology, Shizuoka Prefectural Hospital, Shizuoka, Japan. 13. Department of Cardiovascular Medicine, Hokkaido Ohno Hospital, Sapporo, Japan. 14. Sequoia Hospital, Redwood City, California. 15. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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.
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.