实用临床医药杂志2026，Vol.30Issue(14)：7-15,9.DOI:10.7619/jcmp.20260986
CatLet冠状动脉评分系统预测老年冠心病患者远期预后:一项基于时间依赖性ROC曲线的生存分析研究
Prognostic value of CatLet coronary scoring system in elderly patients with coronary artery disease:a survival analysis based on time-dependent receiver operating characteristic curve
摘要
Abstract
Objective To investigate the risk stratification capability and prognostic prediction value of the coronary artery tree description,lesion evaluation and treatment information collecting system(CatLet coronary scoring system)in elderly patients(age ≥60 years)with coronary heart dis-ease(CHD).Methods Elderly coronary heart disease patients underwent coronary angiography for chest pain at Hefei First People's Hospital from January to December 2018 were consecutively enrolled.Baseline data,biochemical indicators from the first laboratory tests after admission,echocardiographic results,and angiographic images were collected.Residual CatLet(rCatLet)scores were calculated based on angiographic images for all enrolled patients,and a 6-year prognostic follow-up was conduc-ted.The primary endpoint was major adverse cardiovascular and cerebrovascular events(MACCEs),and secondary endpoints included all-cause death and cardiac death.Kaplan-Meier analysis was used to estimate survival rates,Cox regression analysis was performed to identify independent predic-tors of clinical outcomes,and time-dependent area under the curve(tAUC)of receiver operating characteristic curve was used to evaluate the predictive value of rCatLet.Results A total of 208 pa-tients were finally enrolled,with the incidence rates of MACCEs,all-cause death,and cardiac death being 42.31％(88/208),27.88％(58/208)and 16.83％(35/208),respectively.Kaplan-Meier curves for all endpoints showed an increasing trend in event rates with higher rCatLet tertile groups(all log-rank P＜0.001).Multivariable Cox proportional hazards model analysis,adjusted for age,diabetes,left ventricular ejection fraction,and serum creatinine,demonstrated that compared with the low rCatLet tertile group(reference),both the middle and high tertile groups had significantly increased risks of MACCEs[hazard ratio(HR)and 95％confidence interval(95％CI),1.75(0.92 to 3.35)and 4.93(2.73 to 8.93),respectively;trend test P＜0.001].The tAUC(95％CI)of re-ceiver operating characteristic curve analysis revealed that the rCatLet multivariable model at 1-,3-,and 6-year follow-up was 0.84(0.74 to 0.92),0.77(0.70 to 0.85),and 0.82(0.74 to 0.86),respectively.Conclusion The rCatLet coronary scoring system demonstrates good predictive value for MACCEs at 1,3,and 6 years in elderly coronary heart disease patients.A multivariable model incorporating clinical factors can significantly enhance its predictive performance.关键词
冠心病/老年人群/冠状动脉树描述、病变评估及治疗信息收集系统/预后/血管造影术/主要不良心脑血管事件/时间依赖受试者工作特征曲线/生存分析分类
医药卫生引用本文复制引用
徐明星,王静,汪永生,赫兰,王书..CatLet冠状动脉评分系统预测老年冠心病患者远期预后:一项基于时间依赖性ROC曲线的生存分析研究[J].实用临床医药杂志,2026,30(14):7-15,9.基金项目
国家自然科学基金青年科学基金项目(82502378) （82502378）
安徽省卫生健康科研项目(2023-262) （2023-262）
安徽医科大学校基金(2023xkj112) （2023xkj112）
