Wang Juan, Zhang Mingchao, Xu Mingxing, Zhou Jiayan, Lu Dasheng
Department of Cardiology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China.
Department of Geriatrics, The First People's Hospital of Hefei, Hefei, China.
Catheter Cardiovasc Interv. 2025 Feb;105(2):283-291. doi: 10.1002/ccd.31191. Epub 2024 Nov 6.
Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system is a newly developed vascular scoring for assessing the degree of coronary artery stenosis and coronary artery variability. Preliminary studies have demonstrated its superiority over the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score in predicting outcome in patients with acute myocardial infarction (AMI). This study aimed to assess the predictive value of the CatLet score in long-term prognosis after PCI for chronic coronary syndrome (CCS).
A total of 201 patients, who were diagnosed with chronic coronary syndrome, undergoing coronary DES implantation and calculable Catlet score at the Second Affiliated Hospital of Wannan Medical College in China were consecutively enrolled from January 2020 to June 2021. The primary endpoint was major adverse cardiac events (MACEs), defined as a composite of myocardial infarction, recurrent angina, cardiac death, heart failure and ischemia-driven revascularization, were stratified according to CatLet score tertiles: 0 ≤ CatLet_low ≤ 23(n = 66), CatLet_mid 24-43(n = 68), and CatLet_top ≥ 44(n = 67), respectively.
The CatLet score predicted long-term prognosis with a median follow-up of 3.0 years. Of 201 patients analyzed, the rates of MACEs and cardiac death were 25.37% and 3.98%, respectively. The Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the CatLet score, with p-value < 0.05 on the trend test. For MACE and cardiac death, the area under the curve (AUC) of the CatLet score was 0.744 (95% confidence interval [CI]: 0.668-0.820) and 0.804 (95% CI: 0.672-0.936), respectively; Alone or after adjusting for risk factors, the multivariable-adjusted hazard ratio (95% CI)/unit higher score was 9.41 (3.18-27.85) for MACEs and 1.85 (1.20-2.84) for cardiac death, respectively.
The CatLet score is an independent predictor of long-term clinical outcomes in patients with chronic coronary syndrome after percutaneous coronary intervention.
冠状动脉树描述与病变评估（CatLet）血管造影评分系统是一种新开发的用于评估冠状动脉狭窄程度和冠状动脉变异性的血管评分系统。初步研究表明，在预测急性心肌梗死（AMI）患者的预后方面，它优于紫杉醇药物涂层支架与心脏外科手术协同（SYNTAX）评分。本研究旨在评估CatLet评分对慢性冠状动脉综合征（CCS）患者经皮冠状动脉介入治疗（PCI）后长期预后的预测价值。
2020年1月至2021年6月，连续纳入在中国皖南医学院第二附属医院诊断为慢性冠状动脉综合征、接受冠状动脉药物洗脱支架植入且CatLet评分可计算的201例患者。主要终点是主要不良心脏事件（MACE），定义为心肌梗死、复发性心绞痛、心源性死亡、心力衰竭和缺血驱动的血运重建的复合事件，根据CatLet评分三分位数分层：0≤CatLet_low≤23（n = 66）、CatLet_mid 24 - 43（n = 68）和CatLet_top≥44（n = 67）。
CatLet评分在中位随访3.0年时预测长期预后。在分析的201例患者中，MACE和心源性死亡的发生率分别为25.37%和3.98%。所有终点的Kaplan-Meier曲线显示，随着CatLet评分三分位数的增加，结局事件增加，趋势检验p值<0.05。对于MACE和心源性死亡，CatLet评分的曲线下面积（AUC）分别为0.744（95%置信区间[CI]：0.668 - 0.820）和0.804（95%CI：0.672 - 0.936）；单独或在调整危险因素后，多变量调整后的风险比（95%CI）/每高1分，MACE为9.41（3.18 - 27.85），心源性死亡为1.85（1.20 - 2.84）。
CatLet评分是慢性冠状动脉综合征患者经皮冠状动脉介入治疗后长期临床结局的独立预测因素。
