Coronary disease & ACS

Retrograde Coronary Chronic Total Occlusion Intervention (JR-CTO) Score: From the Japanese CTO-PCI Expert Registry

JACC Cardiovasc IntervPublished Prediction model development and validation study

Authors' conclusion

The JR-CTO (Japanese Retrograde Chronic Total Occlusion) score, a simple 4-item score that predicts successful guidewire crossing in patients undergoing retrograde CTO-PCI, has the potential to support clinical decision-making for the retrograde approach.

Study context

Population
Patients undergoing primary retrograde CTO-PCI, Japanese CTO-PCI Expert Registry, January 2016–December 2022
Participants
2,374 patients
Comparison
Derivation vs Validation
Outcome
Guidewire failure in retrograde CTO-PCI (JR-CTO score: 1 point per factor, summed)
Methodological detailsregistry-based, derivation and validation cohorts (2:1 random split), multicentre registry
  • Registry-based
  • Derivation and validation cohorts (2:1 random split)
  • Multicentre registry

Performance

As reported in the abstract

Discrimination of the JR-CTO score for guidewire failure
Test or modelC-statistic
Derivation0.72 (95% CI: 0.67-0.76)
Validation0.71 (95% CI: 0.64-0.77)

C-statistic

Derivation0.72 (95% CI: 0.67-0.76)
Validation0.71 (95% CI: 0.64-0.77)

Further findings

Guidewire and technical success, guidewire crossing time, procedural time by score

Lower scores: higher guidewire and technical success rates, shorter guidewire crossing and procedural times
P < 0.01

Original publication

Retrograde Coronary Chronic Total Occlusion Intervention (JR-CTO) Score: From the Japanese CTO-PCI Expert Registry. JACC Cardiovasc Interv. Published 1 May 2024. doi:10.1016/j.jcin.2024.03.023

Summarised from the published abstract; every number is checked against it

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