Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction.
10.1097/CM9.0000000000002640
- Author:
Mingxing XU
1
;
Shu WANG
1
;
Ying ZHANG
1
;
Jie ZHANG
1
;
Jin MA
1
;
Junfei SHEN
1
;
Yida TANG
2
;
Tingbo JIANG
3
;
Yongming HE
3
Author Information
1. Department of Geriatrics, The Third Affiliated Hospital of Anhui Medical University/Hefei First People's Hospital, Hefei, Anhui 230061, China.
2. Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing 100191, China.
3. Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Coronary Artery Disease/complications*;
Death;
Myocardial Infarction/etiology*;
Percutaneous Coronary Intervention;
Retrospective Studies;
Risk Assessment;
Risk Factors;
Treatment Outcome
- From:
Chinese Medical Journal
2023;136(20):2459-2467
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)-age, creatinine, and ejection fraction, will enhance its predicting values.
METHODS:The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score tertiles: rCatLet_low ≤3, rCatLet_mid 4-11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks.
RESULTS:Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values <0.001 on trend test. For MACCE, all-cause death, and cardiac death, the area under the curves (AUCs) of the rCatLet score were 0.70 (95% confidence intervals [CI]: 0.63-0.78), 0.69 (95% CI: 0.61-0.77), and 0.71 (95% CI: 0.63-0.79), respectively; the AUCs of the CVs-adjusted rCatLet score models were 0.83 (95% CI: 0.78-0.89), 0.87 (95% CI: 0.82-0.92), and 0.89 (95% CI: 0.84-0.94), respectively. The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions.
CONCLUSION:The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability.
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