Iranian Heart Journal

Iranian Heart Journal

Short-term Clinical Outcomes of Patients With Chronic Total Occlusion Who Underwent PCI Using the J-CTO Score

Document Type : Original Article

Authors
Ahmed Ibrahim Bedier 1
Ramy Gamal Elsayed Metwali 2
Mahmoud Mohamed Abdo Youssof 3
Sally Magdy Teima 3
1 Department of Cardiology, Faculty of Medicine, Mansoura University, Dakahlia, Egypt.
2 Cardiology Department, Ministry of Health, Eldakahlia, Egypt.
3 Cardiology Department, Faculty Of Medicine, Mansoura University, Eldakahlia, Egypt.
Abstract
Background: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains a significant challenge in interventional cardiology. Advancements in technology and procedures have facilitated high technical and procedural success rates in PCI for CTO while ensuring a minimal risk of procedural complications. The objective of this study was to assess clinical improvement in patients with coronary CTO who underwent PCI based on the Multicenter Chronic Total Occlusion Registry of Japan (J-CTO) score.

Methods: A prospective observational study was carried out to evaluate clinical improvement in patients with coronary CTO who underwent percutaneous intervention according to the J-CTO score. This study was carried out in the cardiovascular department of Mansoura University Hospitals, Mansoura, Egypt, and was performed over 1 year, from January 2019 through January 2020.

Results: Receiver operating characteristic analysis was carried out to detect the optimal J-CTO score cutoff for the prediction of no improvement (failed cases). The best J-CTO score cutoff value was 2.50. The area under the curve was 0.736 (P = .002). Additionally, logistic regression analysis was carried out to predict major adverse coronary events (MACE) in patients, using laboratory data, demographic data, and J-CTO score as covariates. White blood cell count and J-CTO score were significant risk factors for MACE.

Conclusions: The J-CTO score is a valuable tool for predicting procedural success in patients undergoing CTO PCI, with higher scores associated with a greater likelihood of MACE. (Iranian Heart Journal 2026; 27(3): 6-19)
Keywords
chronic total occlusion
percutaneous coronary intervention
J-Chronic Total Occlusions Score
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Iranian Heart Journal
Volume 27, Issue 3
Summer 2026
Pages 6-19