Prospective Evaluation of Treatment Strategies in Patients Presenting With Chronic Total Occlusion: The PETS‐CTO Registry
Bibliographic record
Abstract
BACKGROUND: The management of patients with chronic total occlusion (CTO) poses a persistent challenge, necessitating a tailored treatment strategy. AIMS: This study aimed to investigate the intricate interplay between treatment selection, ischemia burden reduction, and symptom relief in patients with isolated CTO lesions. METHODS: The Prospective Evaluation of Treatment Strategies in patients presenting with Chronic Total Occlusion (PETS-CTO) registry is a prospective, non-randomized study that evaluated patients at enrollment and follow-up using the Seattle Angina questionnaire (SAQ) and stress ischemia tests. Patients were allocated into three treatment arms: optimal medical therapy (OMT), percutaneous coronary intervention (C TO-PCI), or coronary artery bypass grafting (CABG). Changes in the angina symptoms and ischemic burden were the primary endpoints, while a clinical composite of death, myocardial infarction, and angina-related rehospitalization was considered as the secondary outcome. RESULTS: Among 157 patients, 45% were in the CTO-PCI group, 45% in the OMT group, and 10% underwent CABG. CTO-PCI group demonstrated favorable changes in summary SAQ score (12.3%, 95% CI: 3.4%-21.5%, p = 0.008) compared to OMT. CTO-PCI patients more frequently shifted from an ischemic to a nonischemic stress test at follow-up compared to OMT (60% vs. 5.6%, p < 0.001). No correlation was observed between angina scores and proven ischemia at baseline and follow-up assessments. CONCLUSIONS: Effective management of CTO requires comprehensive evaluation, and although angina relief and ischemic burden are individually influential, our findings reveal a lack of correlation between these factors, emphasizing the complexity in guiding treatment decisions (PETS-CTO; NCT04145167).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".