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

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.