The CatLet score: a new coronary angiographic scoring tool accommodating the variable coronary anatomy for the first time

Xu, Min; Teng, Ruo-Ling; Ruddy, Terrence D.; Schoenhagen, Paul; Bartel, Thomas; Bartolomeo, Roberto Di; Aksoy, Olcay; Desai, Milind Y.; Kodolitsch, Yskert Von; Escaned, Javier; McCullough, Peter A.; Vasudevan, Anupama; Shen, Chengxing; Zhao, Xin; Zhou, Yafeng; Xu, Haifeng; Cheng, Xiaoguang; He, Yao

doi:10.21037/jtd.2019.12.18

Cited by 13 publications

(43 citation statements)

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“…Our CatLet score reflecting the variability in coronary anatomy performed well in terms of risk stratification between the lower two tertiles. Derivation of the CatLet score is based on our weighted matrix, 3 where the weighting factor assignment for coronary artery trees was based on the arterial importance. By contrast, the SYNTAX score was based on the Leaman score, 6 where the weighting factor assignment was largely based on the arterial nomenclature, failing to reflect the variability in coronary anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…Average RCA was judged according to the presence of a significant branch arising from the LCX. 3 The lesion is amplified in the upper right area of Figure 1c. Adverse nonstenotic characteristics pertinent to the lesion were not scored and instead qualitatively recorded as "Yes" or "No."…”

Section: Patientsmentioning

confidence: 96%

“…The CatLet angiographic scoring system has been described elsewhere in detail. 3 In short, it is a comprehensive angiographic scoring system, where the variability in the coronary anatomy is fully accounted for, only a stenosis lesion is scored and further modified if appropriate, and the adverse characteristics pertinent to the lesion are not scored, but only qualitatively recorded. 3 The lesion score is a product of the weighting factor of the blood vessel and its degree of stenosis.…”

Section: The Catlet Score and The Lesion Evaluationmentioning

confidence: 99%

“…The coronary artery tree description and lesion evaluation (CatLet) score, which can account for the variable coronary anatomy, is a recently developed and comprehensive angiographic scoring system aimed at assisting in the risk-stratification of CAD patients. 3 However, a validation of this angiographic scoring system is still lacking.…”

Section: Introductionmentioning

confidence: 99%

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The CatLet score and outcome prediction in acute myocardial infarction for patients undergoing primary percutaneous intervention: A proof‐of‐concept study

Ruddy

Schoenhagen

et al. 2020

Cathet Cardio Intervent

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Background The Coronary Artery Tree description and Lesion EvaluaTion (CatLet) score accommodating the variability in coronary anatomy is a recently developed and comprehensive angiographic scoring system aimed at assisting in risk‐stratification of patients with coronary artery disease. However, a validation of this angiographic scoring system is lacking. Methods The CatLet score was calculated retrospectively in 308 consecutively enrolled patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention. The primary endpoint, major adverse cardiac or cerebrovascular events (MACCEs), was stratified according to CatLet tertiles: CatLetlow ≤14 (n = 124), CatLetmid 15–21 (n = 82) and CatLettop ≥22 (n = 102). Results The CatLet score alone or after adjusting for a broad spectrum of risk factors, significantly predicted clinical outcomes at a median 4.3‐year follow‐up. Multivariable‐adjusted hazard ratios (95%CI)/unit higher score were 1.05 (1.04–1.07) for MACCE, 1.06 (1.04–1.07) for cardiac death, and 1.05 (1.04–1.07) for all‐cause death. When compared to the SYNTAX score, improved discrimination and better calibration of this CatLet score resulted in a significantly refined risk stratification. The overall category‐free net reclassification improvement afforded by this CatLet score was as follows: 37.2% (p = .008) for MACCEs, 35.5% (p = .0249) for cardiac death, and 31.8% (p = .0316) for all‐cause death. Conclusions The ability to integrate the variability in coronary anatomy into angiographic scoring makes the CatLet score a more specific tool for outcome predictions in AMI. (http://http://www.chictr.org.cn. Unique identifiers: ChiCTR‐POC‐17013536).

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 96%

Section: The Catlet Score and The Lesion Evaluationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The CatLet score and outcome prediction in acute myocardial infarction for patients undergoing primary percutaneous intervention: A proof‐of‐concept study

Ruddy

Schoenhagen

et al. 2020

Cathet Cardio Intervent

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“…Recently, we have developed a novel C oronary A rtery T ree description and L esion E valua T ion (CatLet © ) angiographic scoring system, which is capable to account for the variability in the coronary anatomy and to assist in risk-stratification of patients with acute myocardial infarction (AMI) and collection of angiographic data. [ 1 , 2 ] According to this new score's algorithm, only a lesion ≥50% diameter stenosis in vessels >1.5 mm in diameter is scored and further modified if appropriate, and the adverse characteristics pertinent to the lesion are not scored anymore, but only qualitatively recorded instead. [ 2 ] The Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, another angiographic scoring tool, has been widely used to grade the severity and complexity of coronary artery disease (CAD) and to predict clinical outcomes for CAD patients.…”

Section: Introductionmentioning

confidence: 99%

Inter- and intra-observer variability for the assessment of coronary artery tree description and lesion EvaluaTion (CatLet©) angiographic scoring system in patients with acute myocardial infarction

Liu

Teng

Qian

et al. 2020

Chinese Medical Journal

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Background: Previously, we developed a novel C oronary A rtery T ree description and L esion E valua T ion (CatLet © ) angiographic scoring system, which was capable of accounting for the variability in the coronary anatomy and assisting in the risk-stratification of patients with acute myocardial infarction (AMI). Our preliminary study revealed that the CatLet score better predicted clinical outcomes for AMI patients than the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score. However, the reproducibility of the CatLet score in both inter- and intra-observer remains to be evaluated. Methods: A total of 30 consecutive AMI patients, admitted in September of 2015, were independently assessed by two experienced interventional cardiologists to evaluate the inter-observer reproducibility of the CatLet score. Another set of 49 consecutive AMI patients, admitted between September and October in 2014, were assessed by one of the two interventional cardiologists on two occasions 3 months apart to evaluate the intra-observer reproducibility of the CatLet score. The weighted kappa was used to express the degree of agreement. Results: The weighted kappa values (95% confidence interval) for the intra- and inter-observer reproducibility of the CatLet Score were 0.82 (0.59–1.00, Z = 7.23, P < 0.001) and 0.86 (0.54–1.00, Z = 5.20, P < 0.001), respectively, according to the tertile analysis (≤14, 15–22, >22). Regarding the adverse characteristics pertinent to lesions and dominance parameters, the kappa values for the inter-observer variability were 0.80 (0.56–1.00, Z = 6.47, P < 0.001) for total number of lesions, 0.57 (0.28–0.85, Z = 3.03, P < 0.001) for bifurcation, 0.69 (0.43–0.96, Z = 5.06, P < 0.001) for heavy calcification, 1.00 (0.72–1.00, Z = 6.93, P < 0.001) for tortuosity, 0.54 (0.26–0.82, Z = 3.78, P < 0.001) for thrombus, 0.69 (0.48–0.91, Z = 6.29, P < 0.001) for right coronary artery dominance, 0.69 (0.41–0.96, Z = 4.91, P < 0.001) for left anterior descending artery length, and 0.22 (0.06–0.51, Z = 1.56, P = 0.06) for diagonal size. Equivalent values for the intra-observer variability were moderate to almost perfect (range...

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The Predictive Value of the CatLet Scoring System for Long‐Term Prognosis After Percutaneous Coronary Intervention in Patients With Chronic Coronary Syndrome

Wang,

Zhang,

et al. 2024

Cathet Cardio Intervent

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BackgroundCoronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system is a newly developed vascular scoring for assessing the degree of coronary artery stenosis and coronary artery variability. Preliminary studies have demonstrated its superiority over the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score in predicting outcome in patients with acute myocardial infarction (AMI). This study aimed to assess the predictive value of the CatLet score in long‐term prognosis after PCI for chronic coronary syndrome (CCS).MethodsA total of 201 patients, who were diagnosed with chronic coronary syndrome, undergoing coronary DES implantation and calculable Catlet score at the Second Affiliated Hospital of Wannan Medical College in China were consecutively enrolled from January 2020 to June 2021. The primary endpoint was major adverse cardiac events (MACEs), defined as a composite of myocardial infarction, recurrent angina, cardiac death, heart failure and ischemia‐driven revascularization, were stratified according to CatLet score tertiles: 0 ≤ CatLet_low ≤ 23(n = 66), CatLet_mid 24–43(n = 68), and CatLet_top ≥ 44(n = 67), respectively.ResultsThe CatLet score predicted long‐term prognosis with a median follow‐up of 3.0 years. Of 201 patients analyzed, the rates of MACEs and cardiac death were 25.37% and 3.98%, respectively. The Kaplan–Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the CatLet score, with p‐value < 0.05 on the trend test. For MACE and cardiac death, the area under the curve (AUC) of the CatLet score was 0.744 (95% confidence interval [CI]: 0.668–0.820) and 0.804 (95% CI: 0.672–0.936), respectively; Alone or after adjusting for risk factors, the multivariable‐adjusted hazard ratio (95% CI)/unit higher score was 9.41 (3.18–27.85) for MACEs and 1.85 (1.20–2.84) for cardiac death, respectively.ConclusionThe CatLet score is an independent predictor of long‐term clinical outcomes in patients with chronic coronary syndrome after percutaneous coronary intervention.

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The CatLet score: a new coronary angiographic scoring tool accommodating the variable coronary anatomy for the first time

Cited by 13 publications

References 13 publications

The CatLet score and outcome prediction in acute myocardial infarction for patients undergoing primary percutaneous intervention: A proof‐of‐concept study

The CatLet score and outcome prediction in acute myocardial infarction for patients undergoing primary percutaneous intervention: A proof‐of‐concept study

Inter- and intra-observer variability for the assessment of coronary artery tree description and lesion EvaluaTion (CatLet©) angiographic scoring system in patients with acute myocardial infarction

The Predictive Value of the CatLet Scoring System for Long‐Term Prognosis After Percutaneous Coronary Intervention in Patients With Chronic Coronary Syndrome

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