Residual CatLet score and its derived indexes in predicting outcomes in patients with chronic coronary syndrome after percutaneous coronary intervention

Background Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring (CS) system, reflecting coronary artery variability, is a newly developed scoring tool for assessing the degree of coronary artery stenosis. And the residual CatLet score (rCS) has reflected the burden of residual lesions. This study was conducted to explore the utility of the rCS and its derived indexes-Catlet revascularization index (CRI) among patient with chronic coronary syndrome (CCS) after percutaneous coronary intervention (PCI). Methods A study cohort was established comprising patients who received PCI in the Second Affiliated Hospital of Wannan Medical College from May 2019 to July 2020. Patients were divided into tertiles according to the CRI and rCS values. The primary endpoint was major adverse cardiac events (MACEs), including myocardial infarction, cardiac death, heart failure and all-cause mortality, secondary outcome measures were recurrent angina. Results A total of 262 patients were enrolled in this analysis, with mean CRI and rCS scores of 58.08 ± 27.88 and 17.33 ± 15.81, respectively. Kaplan–Meier analysis revealed that higher levels of residual coronary lesions, as measured by rCS and its derivatives, correlated with a higher incidence of adverse cardiovascular events. Multivariable Cox regression analysis demonstrated that CRI [hazard ratio (HR): 0.98; 95% confidence interval (CI): 0.98–0.99; p < 0.001] and rCS (HR: 1.04; 95% CI: 1.02–1.05; p < 0.001) were significant independent predictors of MACEs during long-term follow-up; CRI (HR 0.98, 95% CI 0.98–0.99; p < 0.001) and rCS (HR 1.05, 95% CI 1.03–1.07; p < 0.001) emerged as significant predictors for the risk of recurrent angina. rCS demonstrated superior discriminative ability for MACEs compared to CRI at 6.2 years, with area under the curve values of 0.73 and 0.67, respectively ( p < 0.001). Conclusion This real-world analysis of CCS patients undergoing PCI demonstrated that the rCatlet score offered superior predictive performance for long-term MACEs compared to the CRI.