Residual CatLet score predicts the long-term prognosis in “all-comers” patients with coronary artery disease: a survival analysis study based on time-dependent receiver operating characteristic curves
- 1Department of Geriatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- 2Department of Geriatrics, The Third Hospital Affiliated to Anhui Medical University/The First People’s Hospital of Hefei, Hefei, China
- 3Department of Cardiology, The Third Hospital Affiliated to Anhui Medical University/The First People’s Hospital of Hefei, Hefei, China
Abstract
Background: In recent years, the incidence and mortality rates of coronary artery disease (CAD) have been rising annually. This study aimed to evaluate the ability of the coronary artery tree description and lesion evaluation (CatLet) angiographic scoring system to stratify risk and to elucidate its independent prognostic value in “all-comers” patients with CAD.
Methods: A total of 373 consecutive CAD patients were enrolled at The First People’s Hospital of Hefei following coronary angiography. The residual CatLet (rCatLet) score was calculated based on the residual lesions after completion of required revascularization at physicians’ discretion during this hospitalization for all enrolled patients, who subsequently underwent follow-ups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs). Secondary endpoints included all-cause death and cardiac death. Survival rates were estimated using the Kaplan-Meier method, and Cox regression analysis was performed to identify independent prognostic factors, while the prognostic value of the rCatLet score was evaluated by the time-dependent area under the receiver operating characteristic (ROC) curve (AUC).
Results: This was a single-center cohort study of 279 patients, including 56 (20.07%) with acute coronary syndrome (ACS) and 223 (79.93%) with chronic coronary syndrome (CCS). Kaplan-Meier analysis showed progressively worse prognosis across higher rCatLet score tertiles for all endpoints (all log-rank P<0.001). Cox regression revealed that, compared with the low tertile, the highest rCatLet tertile was associated with a significantly increased risk of MACCEs [hazard ratio (HR) =4.96; 95% confidence interval (CI): 3.03–8.12], and the medium tertile showed a non-significant trend toward higher risk (HR =1.39; 95% CI: 0.79–2.43). Time-dependent ROC analysis showed that the rCatLet model predicted 1-, 3-, and 6-year MACCEs with AUCs (95% CIs) of 0.85 (0.77–0.92), 0.73 (0.64–0.81), and 0.71 (0.64–0.77). The multivariable-adjusted models performed better, and their AUCs (95% CIs) at the three time points were 0.87 (0.83–0.92), 0.78 (0.72–0.86), and 0.78 (0.73–0.84), respectively.
Conclusions: Our exploratory findings suggest that the rCatLet score has predictive value for the short- and long-term clinical prognosis in “all-comers” patients with CAD. Furthermore, the rCatLet score adjusted for clinical variables showed improved prognostic predictive values. These findings require further validation in future studies.
Related
- Perfusion Index as a Predictor of Spinal Anesthesia Success: A Time-dependent Receiver Operating Characteristic Curve Analysis
- Metabolic signature of phosphoethanolamine and arginine pathways predicts prognosis and immunotherapy resistance in lung adenocarcinoma
- A tumor purity-based gene signature predicts prognosis and shapes the immune microenvironment in PAAD
- TRIM3 functions as a tumor suppressor and predicts prognosis in triple-negative breast cancer: a multi-omics study with clinical cohort validation
- Standardization of shotgun metagenomics parameters for pks-positive enterobacteria detection in human fecal samples: Receiver operating characteristic analysis using polymerase chain reaction as reference standard
BibTeX
@article{xu2026residual,
title = {{Residual CatLet score predicts the long-term prognosis in “all-comers” patients with coronary artery disease: a survival analysis study based on time-dependent receiver operating characteristic curves}},
author = {Ming-Xing Xu and Yong-Sheng Wang and Jing Wang and Xue-Qing Ge and Jun-Hong Yang and Shu Wang and De-Fa Zhu},
journal = {Quantitative Imaging in Medicine and Surgery},
year = {2026},
month = sep,
doi = {10.21037/qims-2026-1005},
url = {https://doi.org/10.21037/qims-2026-1005},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Residual CatLet score predicts the long-term prognosis in “all-comers” patients with coronary artery disease: a survival analysis study based on time-dependent receiver operating characteristic curves
AU - Ming-Xing Xu
AU - Yong-Sheng Wang
AU - Jing Wang
AU - Xue-Qing Ge
AU - Jun-Hong Yang
AU - Shu Wang
AU - De-Fa Zhu
PY - 2026
DA - 2026/09/30
JO - Quantitative Imaging in Medicine and Surgery
DO - 10.21037/qims-2026-1005
UR - https://doi.org/10.21037/qims-2026-1005
AB - Background: In recent years, the incidence and mortality rates of coronary artery disease (CAD) have been rising annually. This study aimed to evaluate the ability of the coronary artery tree description and lesion evaluation (CatLet) angiographic scoring system to stratify risk and to elucidate its independent prognostic value in “all-comers” patients with CAD. Methods: A total of 373 consecutive CAD patients were enrolled at The First People’s Hospital of Hefei following coronary angiography. The residual CatLet (rCatLet) score was calculated based on the residual lesions after completion of required revascularization at physicians’ discretion during this hospitalization for all enrolled patients, who subsequently underwent follow-ups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs). Secondary endpoints included all-cause death and cardiac death. Survival rates were estimated using the Kaplan-Meier method, and Cox regression analysis was performed to identify independent prognostic factors, while the prognostic value of the rCatLet score was evaluated by the time-dependent area under the receiver operating characteristic (ROC) curve (AUC). Results: This was a single-center cohort study of 279 patients, including 56 (20.07%) with acute coronary syndrome (ACS) and 223 (79.93%) with chronic coronary syndrome (CCS). Kaplan-Meier analysis showed progressively worse prognosis across higher rCatLet score tertiles for all endpoints (all log-rank P<0.001). Cox regression revealed that, compared with the low tertile, the highest rCatLet tertile was associated with a significantly increased risk of MACCEs [hazard ratio (HR) =4.96; 95% confidence interval (CI): 3.03–8.12], and the medium tertile showed a non-significant trend toward higher risk (HR =1.39; 95% CI: 0.79–2.43). Time-dependent ROC analysis showed that the rCatLet model predicted 1-, 3-, and 6-year MACCEs with AUCs (95% CIs) of 0.85 (0.77–0.92), 0.73 (0.64–0.81), and 0.71 (0.64–0.77). The multivariable-adjusted models performed better, and their AUCs (95% CIs) at the three time points were 0.87 (0.83–0.92), 0.78 (0.72–0.86), and 0.78 (0.73–0.84), respectively. Conclusions: Our exploratory findings suggest that the rCatLet score has predictive value for the short- and long-term clinical prognosis in “all-comers” patients with CAD. Furthermore, the rCatLet score adjusted for clinical variables showed improved prognostic predictive values. These findings require further validation in future studies.
SN - 2223-4292
SN - 2223-4306
ER -