Wang Juan, Yu Rongbo, Zhang Mingchao, Zhou Jiayan, Lu Dasheng, Yang Lingfei
Department of Cardiology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China.
Quant Imaging Med Surg. 2025 Sep 1;15(9):8112-8124. doi: 10.21037/qims-2025-171. Epub 2025 Aug 19.
The 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. It has unique advantages in reflecting coronary artery variability as compared to Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score. Preliminary studies support its superiority over SYNTAX in predicting clinical outcomes after percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS). This study aimed to determine whether the CatLet score incorporating three clinical variables (CVs)-age, ejection fraction, and creatinine-is a better predictor of clinical outcomes in patients treated with PCI for CCS as compared to the CatLet score.
A total of 222 patients who were diagnosed with CCS, underwent coronary drug-eluting stent (DES) implantation, and had a calculable CatLet score were retrospectively selected from the Second Affiliated Hospital of Wannan Medical College in China between April 2019 and June 2020. The primary endpoint was major adverse cardiac events (MACEs), including myocardial infarction, recurrent angina, cardiac death, heart failure, and ischemia-driven revascularization, and was stratified according to CatLet score tertiles as follows: >0 and ≤23= CatLet low (n=72), 24-43= CatLet mid (n=76), and ≥44= CatLet top (n=74).
The CatLet score predicted long-term prognosis, with a 4.5-year-follow-up and a median of 3.4 years. Of the 222 patients analyzed, the rates of MACEs, cardiac death, and reangina were 27.03%, 3.60%, and 18.02%, respectively. In the Kaplan-Meier analysis, as the tertiles of the CatLet score increased, so did the cumulative incidence event rates for all endpoints (log-rank test for trend P<0.05). The area under the curve (AUC) of the CatLet score was 0.73, 0.76, and 0.73 for MACEs, cardiac death, and reangina, respectively, while the AUCs for CV-adjusted CatLet score models were 0.78, 0.88, and 0.74, respectively. Alone or after adjustments for risk factors, the multivariable-adjusted hazard ratio/unit higher score was 6.22 [95% confidence interval (CI): 2.40-16.13] for MACEs, 4.84 (95% CI: 2.52-9.32) for cardiac death, and 8.59 (95% CI: 2.53-29.10) for heart failure.
As compared with CatLet score alone, the model incorporating the CatLet score and three CVs can provide superior prediction ability.
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的血管评分系统。与紫杉醇药物洗脱支架与心脏手术协同作用（SYNTAX）评分相比，它在反映冠状动脉变异性方面具有独特优势。初步研究支持其在预测慢性冠状动脉综合征（CCS）患者经皮冠状动脉介入治疗（PCI）后的临床结局方面优于SYNTAX评分。本研究旨在确定纳入年龄、射血分数和肌酐这三个临床变量（CV）的CatLet评分与单纯CatLet评分相比，是否能更好地预测接受PCI治疗的CCS患者的临床结局。
回顾性选取2019年4月至2020年6月在中国皖南医学院第二附属医院诊断为CCS、接受冠状动脉药物洗脱支架（DES）植入且可计算CatLet评分的222例患者。主要终点是主要不良心脏事件（MACE），包括心肌梗死、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，并根据CatLet评分三分位数进行分层，如下：>0且≤23 = CatLet低分组（n = 72），24 - 43 = CatLet中分组（n = 76），≥44 = CatLet高分组（n = 74）。
CatLet评分预测了长期预后，随访4.5年，中位随访时间为3.4年。在分析的222例患者中，MACE、心源性死亡和再发心绞痛的发生率分别为27.03%、3.60%和18.02%。在Kaplan - Meier分析中，随着CatLet评分三分位数的增加，所有终点的累积发病率事件率也增加（趋势对数秩检验P < 0.05）。CatLet评分对MACE、心源性死亡和再发心绞痛的曲线下面积（AUC）分别为0.73、0.76和0.73，而CV调整后的CatLet评分模型的AUC分别为0.78、...
