{
  "abstract": "Introduction: Chronic total occlusion (CTO) complexity scores were developed to predict procedural difficulty during CTO percutaneous coronary intervention (CTO-PCI). Their value for predicting long-term clinical outcomes remains uncertain.\n\nAim: We investigated the association between commonly used CTO complexity scores and adverse outcomes after CTO-PCI and compared their prognostic performance.\n\nMaterial and methods: This retrospective single-center cohort study included 149 consecutive patients undergoing CTO-PCI. Five CTO complexity scores (J-CTO, RECHARGE, PROGRESS-CTO, CL, and CASTLE) were calculated. The primary endpoint was a composite of all-cause mortality or urgent coronary revascularization. Multivariable Cox regression, receiver operating characteristic (ROC) analysis, and Kaplan-Meier survival analysis were performed.\n\nResults: During a mean follow-up of 17.1 ±10.6 months, the composite endpoint occurred in 30 (20.1%) patients. After adjustment for age, left ventricular ejection fraction, serum creatinine, and albumin, all five CTO scores remained independently associated with the composite outcome. The J-CTO score showed the strongest association (adjusted HR = 2.18, 95% CI: 1.38–3.45; p = 0.001). The CASTLE score had the highest observed ROC-AUC (0.726, p < 0.001), although its discriminatory performance did not differ significantly from that of the J-CTO score. Harrell’s C-index also demonstrated comparable discrimination between the CASTLE and J-CTO scores (both C-index 0.697), indicating modest-to-moderate discriminatory ability. Patients with J-CTO ≥ 2 or CASTLE ≥ 2 had significantly worse event-free survival (log-rank p = 0.013 and p = 0.004, respectively).\n\nConclusions: CTO complexity scores were independently associated with long-term adverse outcomes after CTO-PCI and may have prognostic relevance in addition to their established role in procedural planning. These findings should be confirmed in larger prospective studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Kayseri City Hospital, Kayseri, Turkey"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mehmet K. Teber"
    },
    {
      "affs": [
        0
      ],
      "name": "Mehmet Z. Aydın"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/74dpqzwnc9tka.bib",
  "cited_by": 0,
  "doi": "10.5114/aic.2026.164557",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721082/?tool=EBI",
  "id": "74dpqzwnc9tka",
  "issns": [
    "1734-9338",
    "1897-4295"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13721082",
  "language": "eng",
  "licence": "CC-BY-NC-SA",
  "licence_label": "CC BY-NC-SA",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Paper"
    ],
    [
      "openalex",
      "2746|Coronary Interventions and Diagnostics"
    ]
  ],
  "openalex": "W7213329619",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721082/pdf/?tool=EBI",
  "pmcid": "PMC13721082",
  "pmid": "42964674",
  "published": "2026-09-01",
  "publisher": "Termedia Publishing",
  "ris": "https://research.draconitic.com/paper/74dpqzwnc9tka.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:37Z",
      "native_id": "PMC:PMC13721082",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13721082"
    },
    {
      "first_seen": "2026-11-03T12:21:50Z",
      "native_id": "PMC13721082",
      "source": "pmc",
      "url": "https://doi.org/10.5114/aic.2026.164557"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Coronary Interventions and Diagnostics",
      "subfield": "surgery"
    }
  ],
  "title": "Prognostic value of chronic total occlusion complexity scoring systems beyond procedural planning: a comparative analysis of five contemporary scores in patients undergoing chronic total occlusion percutaneous coronary intervention",
  "title_text": "Prognostic value of chronic total occlusion complexity scoring systems beyond procedural planning: a comparative analysis of five contemporary scores in patients undergoing chronic total occlusion percutaneous coronary intervention",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:50Z",
  "url": "https://research.draconitic.com/paper/74dpqzwnc9tka",
  "venue": "Postepy w kardiologii interwencyjnej = Advances in interventional cardiology",
  "versions": []
}