Abstract 16826: A New Score System for Decision Making During Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients With Multivessel Disease (The CATholic and CHONnam University Hospital Registry [CATCH-ON] Score)
Objectives: The aim of this study was to develop a novel and simple assessment tool for decision making, culprit only or multivessel revascularization, in acute myocardial infarction (AMI) patients with multivessel disease (MVD).
Background: It remains unclear whether the optimal strategy is complete revascularization or only culprit vessel percutaneous coronary intervention (PCI) in AMI patients with MVD.
Methods: A total of 5,025 patients with AMI from 9 centers of 2 universities were registered in prospective COREA-AMI registry (COnvergent REgistry of catholic and chonnAm university for Acute MI) from January 2004 through December 2009. Out of these, we selected 2,630 patients with MVD and treated by culprit only or multivessel PCI. We investigated the patients’ major adverse cardiac events (MACEs) including cardiac death, re-myocardial infarction, coronary bypass grafting, re-PCI during in hospital period and one year clinical follow-up. And we extracted the variables of CATCH-ON (The CATholic and CHONnam university hospital registry) score which represents preference of multivessel PCI rather than culprit only PCI by subgroup analysis according to the various patient’s baseline clinical and angiographic characteristics.
Results: The CATCH-ON score was constructed using eight independent variables (1 point for each variable), age above 65 years, hypertension, diabetes mellitus, high killip class (III or IV), low left ventricular ejection fraction (≤ 50%), low creatine clearance (≤ 60ml/min), high level of high sensitivity C reactive protein (≥ 2.0mg/L), and non culprit vessel of left anterior descending artery or left main, ranged from 0 to 8. The incidence of MACEs had increased linearly with the CATCH-ON score. And, receiver operating characteristic (ROC) curve showed area under the curve of 0.599, and the cut-off value was 3 points (sensitivity: 67%, specificity: 42%) (Figure 2).
Conclusions: The CATCH-ON score is a simple and reasonable method to decide the strategy of PCI and improve the clinical outcomes for AMI patients with MVD. We suggest that the patients who has more than 3 points of CATCH-ON score should undergo multivessel PCI.
- © 2013 by American Heart Association, Inc.