The predictive value of CatLet© angiographic scoring system for long-term prognosis in patients with acute myocardial infarction presenting > 12 h after symptom onset

Abstract

BackgroundWe have recently developed the 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. This study aimed to clarify whether the CatLet score had a predictive value for long-term prognosis in patients with acute myocardial infarction (AMI) presenting > 12 h after symptom onset.Materials and methodsThe CatLet score was calculated for 1,018 consecutively enrolled AMI patients, who were divided into 3 groups according to the CatLet score tertiles. The primary endpoint was major adverse cardiac events (MACEs), defined as a composite of myocardial infarction, cardiac death, and ischemia-driven revascularization; secondary endpoints were all-cause death, cardiac death, myocardial infarction, and ischemia-driven revascularization.ResultsThe CatLet score was capable of predicting long-term prognosis at a median 4.9-year follow-up alone or after adjustment for risk factors. Multivariable-adjusted hazard ratios (95% CI)/unit higher score were 1.06 (1.05–1.08) for MACEs, 1.05 (1.03–1.07) for all-cause death, 1.06 (1.04–1.09) for cardiac death, 1.06 (1.04–1.08) for myocardial infarction, and 1.06 (1.04–1.08) for revascularization. The univariate model showed good calibration (χ2 = 8.25, P = 0.4091) and good discrimination (area under ROC curve = 0.7086) for MACEs.ConclusionThe CatLet score is an independent predictor of long-term clinical outcomes of patients with AMI presenting > 12 h after symptom onset (http://www.chictr.org.cn; Registry Number: ChiCTR2000033730).

Revisit of the CatLet (Hexu) angiographic scoring system: a narrative review

“…In the Kaplan-Meiere analysis, patients in the CatLetmid and in the CatLettop were associated with hazard ratios (95% CI) 1.68 (1.15–2.44)-fold, and 3.59 (2.56–5.03)-fold increased risk of MACEs, respectively. The discriminations and calibrations of the CatLet or Hexu score for MACEs were also good ( 7 ). We also investigated the reproducibility of the CatLet or Hexu angiographic scoring system.…”

Developing and Validating a Simple Risk Score for Patients with Acute Myocardial Infarction

“…The CatLet extended validation trial (ChiCTR2000033730) and the CatLet validation trial (ChiCTR-POC-17013536), both being registered with chictr.org, served as the derivation and validation datasets, respectively [7,8]. All the participants, aged ≥18 years, homogeneous in Chinese Han ethnicity, were consecutively enrolled.…”

Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction

“…[ 13 ] We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. [ 14 ] Our preliminary studies demonstrated that this novel angiographic scoring system was better than the SYNTAX score to account for the variability in the coronary anatomy, to evaluate the severity and the complexity of diseased coronary artery trees, and to predict clinical outcomes for AMI patients, [ 15 , 16 ] with high reproducibility. [ 17 ] Our prior study also demonstrated that the predictive value of the CatLet score could be improved through a combination with age, serum creatinine, and left ventricular ejection fraction (LVEF).…”