CatLet score and clinical CatLet score as predictors of long-term outcomes in patients with acute myocardial infarction presenting later than 12 hours from symptom onset.

BACKGROUND: Our recently developed Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system is unique in its description of the variability in the coronary anatomy, the degree of stenosis of a diseased coronary artery, and its subtended myocardial territory, and can be utilized to predict clinical outcomes for patients with acute myocardial infarction (AMI) presenting ≤12 h after symptom onset. The current study aimed to assess whether the Clinical CatLet score (CCS), as compared with CatLet score (CS), better predicted clinical outcomes for AMI patients presenting >12 h after symptom onset. METHODS: CS was calculated in 1018 consecutive AMI patients enrolled in a retrospective registry. CCS was calculated by multiplying CS by the ACEF I score (age, creatinine, and left ventricular ejection fraction). Primary endpoint was major adverse cardiac events (MACEs) at 4-year-follow-up, a composite of cardiac death, myocardial infarction, and ischemia-driven revascularization. RESULTS: Over a 4-year follow-up period, both scores were independent predictors of clinical outcomes after adjustment for a broad spectrum of risk factors. Areas-under-the-curve (AUCs) for CS and CCS were 0.72(0.68-0.75) and 0.75(0.71-0.78) for MACEs; 0.68(0.63-0.73) and 0.78(0.74-0.83) for all-cause death; 0.73(0.68-0.79) and 0.83(0.79-0.88) for cardiac death; and 0.69(0.64-0.73) and 0.75(0.7-0.79) for myocardial infarction; and 0.66(0.61-0.7) and 0.63(0.58-0.68) for revascularization, respectively. CCS performed better than CS in terms of the above-mentioned outcome predictions, as confirmed by the net reclassification and integrated discrimination indices. CONCLUSIONS: CCS was better than CS to be able to risk-stratify long-term outcomes in AMI patients presenting >12 h after symptom onset. These findings have indicated that both anatomic and clinical variables should be considered in decision-making on management of patients with AMI presenting later.

High-efficient capture and degradation of formaldehyde based on the electric-field-enhanced catalytic effect.

Enhancing the generation of active groups is of great significance for alleviating the catalyst deactivation of formaldehyde (HCHO) by accelerating the decomposition of intermediate products. Herein, an electric-field-enhanced catalytic effect was proposed for the efficient capture and degradation of HCHO base on carbon cloth loaded manganese oxide catalyst (MnOx-CC). Under the action of electric field, MnOx can generate more hydroxyl radicals (•OH) and superoxide radicals (•O2-), thus accelerating the degradation of HCHO and intermediates at room temperature. After the introduction electric field (∼1 ×104 V/m), •O2- and •OH radical on the surface of MnOx-CC catalyst can be increased by 8 times and 23 times, respectively. At weight hourly space velocity of 300,000 mL/(gcat h) for ∼15 ppm HCHO, MnOx-CC-Electric Field catalyst reached the removal efficiency of 99.4%, and the CO2 conversion efficiency of 81.2%, without decrease significantly within 80 h. Theoretical calculation shows that the electric field can increase the electron state density of Mn atom at the Fermi level and reduce the adsorption energy of HCHO, O2 and H2O, thus promoting the generation of active groups and degradation of intermediate products. The electric-field-enhancement catalytic effect provides a new approach for the degradation of Volatile Organic Compounds.

Adsorption-enhanced catalytic oxidation for long-lasting dynamic degradation of organic dyes by porous manganese-based biopolymeric catalyst.

Improving the adsorption kinetics of metal-oxide catalysts is critical for the enhancement of catalytic performance in heterogeneous catalytic oxidation reactions. Herein, based on the biopolymer pomelo peels (PP) and metal-oxide catalyst manganese oxide (MnOx), an adsorption-enhanced catalyst (MnOx-PP) was constructed for catalytic organic dyes oxidative-degradation. MnOx-PP shows excellent methylene blue (MB) and total carbon content (TOC) removal efficiency of 99.5 % and 66.31 % respectively, and keeps the long-lasting stable dynamic degradation efficiency during 72 h based on the self-built continuous single-pass MB purification device. The chemical structure similarity and negative-charge polarity sites of the biopolymer PP improve the adsorption kinetics of organic macromolecule MB, and construct the adsorption-enhanced catalytic oxidation microenvironment. Meanwhile, the adsorption-enhanced catalyst MnOx-PP obtains lower ionization potential and O2 adsorption energy to promote the continuous generation of active substance (O2*, OH*) for the further catalytic oxidation of adsorbed MB molecules. This work explored the adsorption-enhanced catalytic oxidation mechanism for the degradation of organic pollutants, and provided a feasible technical idea for designing adsorption-enhanced catalysts for the long-lasting efficient removal of organic dyes.

Age, Serum Creatinine, and Left Ventricular Ejection Fraction Improved the Performance of the CatLet Angiographic Scoring System in Terms of Outcome Predictions for Patients with Acute Myocardial Infarction: A Median 4.3-Year Follow-Up Study.

BACKGROUND: We recently developed the Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary study demonstrated that the CatLet score better predicted clinical outcomes than the SYNTAX score. The current study aimed at assessing whether 3 clinical variables (CVs) - age, serum creatinine, and left ventricular ejection fraction (LVEF) - improved the performance of the CatLet score in outcome predictions in patients with acute myocardial infarction (AMI). METHODS: This study was a post hoc study of the CatLet score validation trial. Primary endpoint was major adverse cardiac or cerebrovascular events (MACCEs), and secondary endpoints were all-cause deaths and cardiac deaths. RESULTS: Over 1,185 person-years (median [interquartile range], 4.3 [3.8-4.9] years), there were 64 MACCEs (20.8%), 56 all-cause deaths (18.2%), and 47 cardiac deaths (15.2%). The addition of the 3 CVs to the stand-alone CatLet score significantly increased the Harrell's C-index by 0.0967 (p = 0.002) in MACCEs, by 0.1354 (p < 0.001) in all-cause deaths, and by 0.1187 (p = 0.001) in cardiac deaths. When compared with the stand-alone CatLet score, improved discrimination and better calibration led to a significantly refined risk stratification, particularly at the intermediate-risk category. CONCLUSIONS: CatLet score had a predicting value for clinical outcome in AMI patients. This predicting value can be improved through a combination with age, serum creatinine, and LVEF (http://www.chictr.org.cn; unique identifier: ChiCTR-POC-17013536).

Interaction between lipoprotein (a) levels and body mass index in first incident acute myocardial infarction.

BACKGROUND: Possible interaction between Lipoprotein (a) (Lp(a)) and body mass index (BMI) was investigated with regard to the risk of first incident acute myocardial infarction (AMI). METHODS: Cross-sectional study of 1522 cases with initial AMI and 1691 controls without coronary artery disease (CAD) were retrospectively analyzed using logistic regression model. Subjects were categorized based on Lp(a) and BMI and compared with regard to occurrence of AMI by calculating odds ratios (ORs) with 95% confidence intervals (CIs). A potential interaction between Lp(a) and BMI was evaluated by the measures of effect modification on both additive (Relative excess risk due to interaction, RERI) and multiplicative scales. RESULTS: Compared with reference group (BMI < 24 kg/m2 and in the first quintile of Lp(a)), multivariable-adjusted analysis revealed that ORs(95%CI) of AMI were 2.27(1.46-3.52) for higher BMI alone; 1.79(1.11-2.90), 1.65(1.05-2.60), 1.96(1.20-3.20) and 2.34(1.47-3.71) for higher Lp(a) alone across its quintiles; and 2.86(1.85-4.40), 3.30(2.14-5.11), 4.43(2.76-7.09) and 5.98(3.72-9.60) for both higher BMI and higher Lp(a), greater than the sum of the both risks each. Prominent interaction was found between Lp(a) and BMI on additive scale (RERI = 2.45 (0.36-4.54) at the fifth quintile of Lp(a)) but not on multiplicative scale. CONCLUSIONS: This study demonstrates that BMI and Lp(a) levels are important factors affecting the risk of AMI. Significant interaction is found between Lp(a) and BMI in initial AMI on additive scale, indicating that Lp(a) confers greater risk for initial AMI when BMI is elevated. For those whose BMIs are inadequately controlled, Lp(a) lowering may be an option. TRIAL REGISTRATION: This clinical study was not registered in a publicly available registry because this study was a retrospective study first started in 2015. Data are available via the correspondent.