• Tao Tian, Changdong Guan, Lijian Gao, Jianson Yuan, Jingang Cui, Fenghuan Hu, Yida Tang, Kefei Dou, Yongjian Wu, Yuejin Yang, Shubin Qiao, Bo Xu, and Weixian Yang.
• Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, Beijing, China.
• Eur. J. Clin. Invest. 2021 Feb 1; 51 (2): e13368.

BackgroundIt is ill-defined which factors affect the prognosis of patients with recanalized chronic total occlusion (CTO). This study sought to investigate predictors for adverse outcome in such a cohort with long-time follow-up.MethodsFrom 2010 to 2013, patients with successfully recanalized CTO were included. The primary endpoint was a composite of all-cause death, myocardial infarction or target vessel revascularization (TVR). The secondary endpoints were TVR and target lesion revascularization (TLR).ResultsA total of 1987 patients were enrolled and 1806 (90.6%) subjects completed 5-year follow-up. Multivariate Cox analysis revealed that age ≥ 75 years (HR,1.70; 95% CI, 1.09-2.64; P = .02), left ventricular ejection fraction <40% (HR, 1.94; 95% CI, 1.02-3.69; P = .04) and residual SYNTAX score (HR, 1.02; 95% CI, 1.01-1.04; P = .01) were predictors for the primary endpoint. Non-LAD CTO (HR, 1.82; 95% CI, 1.23-2.70; P < .01), J-CTO score (HR, 1.31; 95% CI, 1.11-1.54; P < .01) and residual SYNTAX score (HR, 1.02; 95% CI, 1.00-1.04; P = .04) were independently related to TVR. Non-LAD CTO, high J-CTO score and residual SYNTAX score was also correlated with TLR.ConclusionsAdvanced age, left ventricular dysfunction and residual SYNTAX score were predictors for composite cardiovascular events in patients with CTO after revascularization. Those with non-LAD CTO, high J-CTO and residual SYNTAX score had higher risk for revascularization.© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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