D-45 | J-CTO score as a predictor for outcomes after percutaneous coronary intervention of chronic total occlusions

Recently, there is growing evidence suggests that successful CTO PCI leads to symptoms and left ventricular function improvement. Recent advances in the interventional techniques and CTO expertise have resulted in higher procedural success rates and lower major complications. It has been suggested to use the Japanese CTO (J-CTO) score to categorize case complexity and procedural success rates. We intended to study the J CTO score as a predictor for the clinical outcomes of CTO PCI. This study is an observational study conducted over 160 CTO patients successfully underwent PCI. It took place from February 2021 till June 2023. We analyzed patient's demographic, clinical and angiographic data, calculation of J-CTO score and incidence of periprocedural complications. Patients were followed up for 6 months after PCI for symptoms improvement (angina and dyspnea according to (CCS) and (NYHA) classes respectively), LVEF change with Echo assessment using Simpson method and incidence of MACEs. Mean age in years is 57.10 ± 10.30. There was a statistically significant improvement in symptoms (dyspnea and angina) and LVEF at 6 months after CTO PCI (P 3, while ROC curve analysis of J-CTO score as a predictor for dyspnea, angina and EF improvement showed sensitivity 49%, 47.93% and 52% and specificity 78.38%, 86.36% and 96.77 respectively with cutoff value = 3 and periprocedural complications (P 0.007), as well as J-CTO score < 3 and improvement of dyspnea (P 0.001), angina (P<0.001) and LVEF (P 0.000); however, non-significant relationship existed between J-CTO score and MACEs within 6 months after PCI (P 0.290). Multivariate logistic regression analysis revealed that J-CTO score <=2 is independent predictor for improvement of dyspnea (P 0.004), angina (P 0.006) and LVEF (P 0.001) at 6 months after PCI. J-CTO score can be useful in preprocedural clinical decision making as it has a predictive value for periprocedural complications and 6 months clinical outcomes in patients who underwent CTO PCI.