Wang Juan, Zhang Mingchao, Gan Weipeng, Xu Mingxing, Zhou JiaYan, Yang Lingfei, Ke Yongsheng
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.
J Cardiothorac Surg. 2025 Jan 29;20(1):106. doi: 10.1186/s13019-025-03349-2.
He's team have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system, which is capable of accounting for the variability in coronary anatomy, and risk-stratifying patients with coronary artery disease. Preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. However, there are fewer studies on the prognostic in chronic coronary artery disease(CAD). This study aimed to clarify whether the CatLet score had a predictive value for in-stent restenosis(ISR) in patients with chronic coronary artery disease undergoing percutaneous coronary intervention with drug-eluting stent(DES).
A total of 260 patients who were diagnosed with chronic CAD and underwent coronary DES implantation at the second affiliated Hospital of Wannan medical college in China were consecutively enrolled from January 2020 to June 2021.Finally, 164 patients underwent the second angiography after 2 years.According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group (n = 26) and the non-ISR group (n = 139).
A total of 165 patients (46 women and 119 men) with a mean ages of 66.19 ± 10.54 years were finally enrolled in this study. Of these, ISR occurred in 26/165 chronic CAD patients (15.76%) by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly the history of chronic obstructive pulmonary disease(COPD), adverse lesion characteristic, higher Catlet score compared with patients in the non-ISR group.The CatLet score was capable of predicting in-stent restenosis after adjustment for risk factors; The Multivariable-adjusted model showed good calibration and good discrimination (area under ROC curve = 0.7164) for ISR.
CatLet score is a new predictor of ISR in patients with chronic CAD after coronary DES implantation.
他的团队最近开发了一种新的冠状动脉树描述和病变评估（CatLet）血管造影评分系统，该系统能够解释冠状动脉解剖结构的变异性，并对冠心病患者进行风险分层。初步研究表明，在急性心肌梗死（AMI）患者的预后预测方面，该系统优于紫杉醇药物涂层支架与心脏手术协同研究（SYNTAX）评分。然而，关于慢性冠状动脉疾病（CAD）预后的研究较少。本研究旨在阐明CatLet评分对接受药物洗脱支架（DES）经皮冠状动脉介入治疗的慢性冠状动脉疾病患者支架内再狭窄（ISR）是否具有预测价值。
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CAD并接受冠状动脉DES植入术的260例患者。最后，164例患者在2年后接受了第二次血管造影。根据随访血管造影是否检测到ISR，将患者分为ISR组（n = 26）和非ISR组（n = 139）。
本研究最终纳入165例患者（46例女性和119例男性），平均年龄为66.19±10.54岁。其中，26/165例慢性CAD患者（15.76%）经随访血管造影发生ISR。单因素分析显示，ISR组和非ISR组的大多数基线特征相似。与非ISR组患者相比，ISR组患者慢性阻塞性肺疾病（COPD）病史、不良病变特征、CatLet评分更高。在调整风险因素后，CatLet评分能够预测支架内再狭窄；多变量调整模型对ISR显示出良好的校准和良好的辨别力（ROC曲线下面积 = 0.7164）。
CatLet评分是冠状动脉DES植入术后慢性CAD患者ISR的新预测指标。
