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

BackgroundWe have recently developed the Coronary Artery Tree description and Lesion EvaluaTion (CatLet (c)) 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 (chi(2) = 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 (; Registry Number: ChiCTR2000033730).