UTILITY OF J-CTO SCORE IN PREDICTING THE PROCEDURAL OUTCOMES IN CORONARY CHRONIC TOTAL OCCLUSION INTERVENTIONS: AN EXPERIENCE AT AFIC/NIHD

Abstract

Objective: To evaluate the performance of the J-CTO score for predicting final success rate of Percutaneous Coronary Intervention among Coronary chronic total occlusions (CTOs) cases performed at AFIC/NIHD.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Inpatient department of Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from Jul 2018 to Dec 2018.

Material and Methods: It was a descriptive cross sectional study conducted at inpatient department of AFIC/NIHD, Rawalpindi from Jul 2018 to Dec 2018. All consecutive patients scheduled to undergo PCI on a CTO of a native coronary artery were considered for enrollment. Total of 68 patients were included in this study. Coronary chronic total occlusions (CTOs) were defined as 100% occlusions in the coronary arteries with Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 of at least 3 months duration. Where duration was not known, estimation of the occlusion duration was made on the first onset of angina or dyspnea and/or prior history of myocardial infarction in the target vessel territory or the results of previous angiography. The clinical and angiographic characteristics as well as procedural outcomes were compared between easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO≥3) CTO lesions. Baseline, procedural and hospitalization data were prospectively collected and entered in a dedicated database. Successful angiographic recanalization was defined as a restoration of TIMI flow grade 3 and residual stenosis 25% of the baseline value. Neither occluded arterial graft nor vein graft lesions were considered for this study. Ethical and institutional approval was taken from the institutional ethical review board.

Results: Among 68 included patients, male patients were 56 (82.4%), while females were 12 (17.6%). ANOVA test was used to find out the association of JCTO score with age, which showed statistical significance (p<0.001). Chi-square test was applied to find out the association between JCTO score and gender, diabetes mellitus, hypertension, dyslipidemia, smoking history, previous history of MI and success of procedure. Test result showed that gender, diabetes mellitus, hypertension, smoking history, previous history of MI and success of procedure are statistically significant with JCTO-score with p-value<0.05.

Conclusions: This study has showed utility of JCTO score in predicting the procedural outcome and its association with technical success rates in CTOs case.