| Objective:The present study aimed to assess the inter-observer and intra-observer variability of the CatLet angiographic scoring system.Background:This research group first developed a new CatLet angiographic scoring system based on the 17 myocardial segment model.Our preliminary study revealed that this new scoring system can be used for angiographic data collections and long-term outcome predictions of patients with acute myocardial infarction(AMI).However,the inter-observer and intra-observer variability of this new CatLet coronary angiographic scoring system in patients with AMI have not been assessed.Methods:A total of 66 consecutive patients referred for coronary angiography suspected of myocardial infarction made up our study population to assess the intra-observer reproducibility and the patients were retrospectively enrolled from Chest pain center,the First Affiliated Hospital of Soochow University,from September 01,2014 to October 09,2014.A total of 54 consecutive patients referred for coronary angiography suspected of myocardial infarction made up our study population to assess the inter-observer reproducibility and the patients were retrospectively enrolled from Chest pain center,the First Affiliated Hospital of Soochow University,from September 07,2015 to September 30,2015.We collected the information on the medical history and coronary angiograms.According to the tutorial for CatLet score calculator available on the website(www.catletscore.com),2 experienced interventional cardiologists,evaluated independently the CatLet score of angiograms in inter-observer study population to assess the inter-observer reproducibility.One of the observers,on two occasions 3 months apart,evaluated the CatLet score of angiograms in intra-observer study population to assess the intra-observer reproducibility.The extent of intra-and inter-observer agreement beyond the level of chance was measured as a percentage of the total agreement using the kappa statistic.This is routinely used to assess the level of agreement between two or more categorical observations in excess of a chance agreement.And we calculated the weighted kappa to allow the relative differences between categorical variables to be appropriately quantified.Statistical analyses were completed with STATA 13.1.The Kappa value ranges from-1 to 1,it makes sense if it is greater than 0.The larger the Kappa value is,the better the agreement is.Results:According to the inclusion criteria and exclusion criteria,we enrolled a total of 49 patients for intra-observer study and a total of 30 patients for inter-observer study.(1)For the intra-observer reproducibility of the CatLet coronary scoring system in AMI patients:the weighted kappa value for the Catlet score according to the terciles≤14,15~22,>22 was 0.82.Kappa values for severe calcification,trifurcation lesions,bifurcation lesions,length>20 mm,tortuosity and thrombus were 0.89,1.00,0.85,0.66,0.65 and 0.77,respectively.The weighted Kappa values for the LAD length,the Dx size,the RCA dominance and the total number lesions were 0.85,0.54,0.62 and 0.87,respectively.(2)For the inter-observer reproducibility of the Catlet coronary scoring system in AMI patients:the weighted kappa value for the CatLet score according to the terciles<14,15-22,>22 was 0.86.Kappa values for severe calcification,bifurcation lesions,tortuosity and thrombus were 0.69,0.57,1.00 and 0.54,respectively.The weighted Kappa values for the LAD length,the Dx size,the RCA dominance and the total number lesions were 0.69,0.22,0.69 and 0.80,respectively.Conclusion:This study first assessed the intra-and inter-observer reproducibility of the CatLet angiographic scoring system in AMI patients.The inter-observer and intra-observer reproducibility of the CatLet angiographic scoring system for assessment of the stenotic lesions and their pertinent adverse angiographic characteristics was substantial or excellent. |
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