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Published on: October 14, 2016
Predictive Values of the CatLet© Angiographic Scoring System for 30-Day Cardiac Mortality in Patients after Primary
Chenjie Zhang1, Wenhui Liang1, Zongliang Yu1
1Department of Cardiology, The First People's Hospital of Kunshan, 215300 Kunshan, Jiangsu, China.
Insights
The CatLet© score effectively predicts short-term cardiac death in acute myocardial infarction (AMI) patients post-primary percutaneous coronary intervention (pPCI). Higher CatLet© scores indicate a significantly increased risk of cardiac mortality within 30 days.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- The Coronary Artery Tree Description and Lesion Evaluation (CatLet©) scoring system is a novel tool for predicting long-term outcomes in acute myocardial infarction (AMI) patients.
- This study evaluated the CatLet© score's predictive value for 30-day cardiac mortality following primary percutaneous coronary intervention (pPCI) in AMI patients.
Purpose of the Study:
- To assess the efficacy of the CatLet© angiographic scoring system in predicting short-term cardiac mortality.
- To determine the association between CatLet© score tertiles and 30-day cardiac death risk in AMI patients undergoing pPCI.
Main Methods:
- A cohort of 308 AMI patients undergoing pPCI were enrolled and categorized into three CatLet© score tertiles (low, mid, top).
- Cardiac mortality at 30 days was the primary endpoint, analyzed using Kaplan-Meier survival curves and Cox regression.
- The predictive performance was assessed using the area under the receiver operating characteristic (ROC) curve (AUC).
Main Results:
- A total of 19 cardiac deaths (6.17%) occurred within 30 days.
- The CatLet-top tertile (score ≥22) showed a significantly higher risk of cardiac mortality compared to lower tertiles (p < 0.01).
- The CatLet© score was an independent predictor of 30-day cardiac mortality (HR: 6.13) with an AUC of 0.80, indicating good predictive accuracy.
Conclusions:
- The CatLet© score is a valuable tool for predicting short-term cardiac death in AMI patients post-pPCI.
- A CatLet© score of ≥22 is significantly associated with poor prognosis, highlighting its clinical utility in risk stratification.
Background:
The Coronary Artery Tree Description and Lesion Evaluation (CatLet©) angiographic scoring system is a newly developed tool to predict the long-term clinical outcomes for patients with acute myocardial infarction (AMI). This study aimed to evaluate the predictive value of this novel angiographic scoring system for cardiac mortality in AMI patients within 30 days of primary percutaneous coronary intervention (pPCI) in AMI patients.
Methods:
Patients with AMI undergoing pPCI were consecutively enrolled between January 2012 and July 2013. The CatLet© score was calculated for all the lesions in the non-occlusive status and were tertile partitioned into three groups: CatLet-low ≤14 (N = 124), CatLet-mid 14-22 (N = 82), and CatLet-top ≥22 (N = 102). The primary endpoint was cardiac mortality at 30 days after the procedure. Survival curves were generated using the Kaplan-Meier method, and survival rates among the CatLet© score tertiles were compared using the Log-rank test. Furthermore, Cox regression analysis was performed to identify the associations between the predictors and clinical outcomes.
Results:
A total of 308 patients were included in the final analysis. The included patients were followed up for 30 days, with 19 (6.17%) cardiac death. Kaplan-Meier curves indicated that the CatLet-top tertile exhibited a significant increase in the risk of cardiac mortality when compared with the low and mid tertiles (p for trend <0.01); the CatLet© score remained an independent predictor of 30-day cardiac mortality in AMI patients after adjusting for clinical variables (HR (95% CI): 6.13 (1.29-29.17); p < 0.01). The multivariable analysis demonstrated that a per 1 unit increase in CatLet© score was associated with a 1.04 (1.01-1.06)-fold increased risk of cardiac death. The area under the receiver operating characteristic (ROC) curve (AUC) statistic for the CatLet© score was 0.80 (95% CI, 0.69-0.91), with a good calibration (χ2 = 12.92; p = 0.12).
Conclusion:
The CatLet© score can be used to predict the short-term cardiac death in AMI patients. A CatLet© score ≥22 or ≥11 myocardial segments involved relative to the total 17 segments (the score divided by 2), including culprit or non-culprit vessels, accounting for 65% (11/17) of left ventricle mass involved, is significantly associated with poor prognosis. The current study has extended the application of the CatLet© score in clinical practice.
Clinical Trial Registration:
ChiCTR-POC-17013536. Registered 25 November, 2017, https://www.chictr.org.cn/showproj.html?proj=22814.
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