Residual coronary artery tree description and lesion EvaluaTion(CatLet)score,clinical variables,and their associations with outcome predictions in patients with acute myocardial infarction

Background:We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion(CatLet)angiographic scoring system.Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention(PCI)with Taxus and Cardiac Surgery(SYNTAX)score with respect to outcome predictions for acute myocardial infarction(AMI)patients.The current study hypothesized that the residual CatLet(rCatLet)score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables(CVs)-age,creatinine,and ejection fraction,will enhance its predicting values.Methods:The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI.Primary endpoint,major adverse cardiac or cerebrovascular events(MACCE)including all-cause mortality,non-fatal AMI,transient ischemic attack/stroke,and ischemia-driven repeat revascularization,was stratified according to rCatLet score tertiles:rCatLet_low≤3,rCatLet_mid 4-11,and rCatLet_top≥12,respectively.Cross-validation confirmed a reasonably good agreement between the observed and predicted risks.Results:Of 308 patients analyzed,the rates of MACCE,all-cause death,and cardiac death were 20.8%,18.2%,and 15.3%,respectively.Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score,with P values<0.001 on trend test.For MACCE,all-cause death,and cardiac death,the area under the curves(AUCs)of the rCatLet score were 0.70(95%confidence intervals[CI]:0.63-0.78),0.69(95%CI:0.61-0.77),and 0.71(95%CI:0.63-0.79),respectively;the AUCs of the CVs-adjusted rCatLet score models were 0.83(95%CI:0.78-0.89),0.87(95%CI:0.82-0.92),and 0.89(95%CI:0.84-0.94),respectively.The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions.Conclusion:The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability.Trial Registration:http://www.chictr.org.cn,ChiCTR-POC-17013536.

THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese withchronic periodontitis. Methods Moderate to advanced chronic periodontitis ( CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fluctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PlI) , gingival index (GI) , bleeding on probing (BOP) , probing depth (PD) and clinical attachment loss (AL) of all patients were recorded at 6 sites on each tooth at the baseline and 1, 3 and 6 months after oral hygiene instruction (OHI), scaling and root planing. Results It was found that the short-term effect of non-surgical periodon-tal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.