Why the study?
In patients with chronic total occlusion on coronary angiography, non-invasive myocardial viability assessment guides revascularization but is often limited by myocardial fibrosis.
Do circulating fibrosis biomarkers and non-invasive imaging improve myocardial viability assessment in patients with chronic total occlusion?
Population
Patients with chronic total occlusion on coronary angiography across 76 studies
Design
Narrative review of 76 studies
Key result
Circulating fibrosis biomarkers such as PICP, PIIINP, and Gal-3 reflect myocardial remodeling and may complement imaging, but currently lack outcome-based validation to guide revascularization.
Authors
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Fibrosis limits current viability tests in CTO; leaves optimal non-invasive strategy open for prospective validation.
Do circulating fibrosis biomarkers and non-invasive imaging improve myocardial viability assessment in patients with chronic total occlusion?
Circulating fibrosis biomarkers show potential to complement imaging in assessing myocardial viability in CTO patients, but require standardization and large-scale validation before clinical implementation.
Tomašić et al. (2026) conducted a review in Chronic total occlusion and myocardial fibrosis (n=76). Circulating fibrosis biomarkers (PICP, PIIINP, Gal-3) and non-invasive imaging was evaluated. Circulating fibrosis biomarkers such as PICP, PIIINP, and Gal-3 reflect myocardial remodeling and may complement imaging, but currently lack outcome-based validation to guide revascularization.
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