Prognostic value of chronic total occlusions detected on coronary computed tomographic angiography

M.P. Opolski, H. Gransar, Y. Lu, S. Achenbach, M.H. Al-Mallah, D. Andreini, J.J. Bax, D.S. Berman, M.J. Budoff, F. Cademartiri, T.Q. Callister, H.-J. Chang, K. Chinnaiyan, B.J.W. Chow, R.C. Cury, A. DeLago, G.M. Feuchtner, M. Hadamitzky, J. Hausleiter, P.A. KaufmannY.-J. Kim, J.A. Leipsic, E.C. Maffei, H. Marques, G. Pontone, G. Raff, R. Rubinshtein, L.J. Shaw, T.C. Villines, M. Gomez, E.C. Jones, J.M. Peña, J.K. Min, F.Y. Lin

Research output: Contribution to journalArticlepeer-review


Objective: Data describing clinical relevance of chronic total occlusion (CTO) identified by coronary CT angiography (CCTA) have not been reported to date. We investigated the prognosis of CTO on CCTA. Methods: We identified 22 828 patients without prior known coronary artery disease (CAD), who were followed for a median of 26 months. Based on CCTA, coronary lesions were graded as normal (no atherosclerosis), non-obstructive (1%-49%), moderate-to-severe (50%-99%) or totally occluded (100%). All-cause mortality, and major adverse cardiac events defined as mortality, non-fatal myocardial infarction and late coronary revascularisation (≥90 days after CCTA) were assessed. Results: The distribution of patients with normal coronaries, non-obstructive CAD, moderate-to-severe CAD and CTO was 10 034 (44%), 7965 (34.9%), 4598 (20.1%) and 231 (1%), respectively. The mortality rate per 1000 person-years of CTO patients was non-significantly different from patients with moderate-to-severe CAD (22.95; 95% CI 12.71 to 41.45 vs 14.46; 95% CI 12.34 to 16.94; p=0.163), and significantly higher than of those with normal coronaries and non-obstructive CAD (p
Original languageEnglish
Pages (from-to)196-203
Number of pages8
Issue number3
Publication statusPublished - Jul 30 2018


  • cardiac computer tomographic (ct) imaging
  • heart disease


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