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SYNTAX Score and SYNTAX Score II Can Predict the Clinical Outcomes of Patients with Left Main and/or 3-Vessel Disease Undergoing Percutaneous Coronary Intervention in the Contemporary Cobalt-Chromium Everolimus-Eluting Stent Era
Korean Circulation Journal ; : 22-34, 2020.
Article in English | WPRIM | ID: wpr-786215
ABSTRACT
BACKGROUND AND

OBJECTIVES:

The impact of SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery score (SS) and SS II in patients who receive percutaneous coronary intervention with second-generation everolimus-eluting stents (EES) has not been fully validated.

METHODS:

The SS, SS II were calculated in 1,248 patients with left main and/or 3-vessel disease treated with EES. Patient-oriented composite endpoint (POCE; all-cause death, any myocardial infarction (MI), any revascularization) and target lesion failure (TLF cardiac death, target-vessel MI, target lesion revascularization) were analyzed.

RESULTS:

The mean SS was 21.1±9.6. Three-year POCE increased according to the SS group (15.2% vs. 19.9% vs. 27.4% for low (≤22), intermediate (≥23, ≤32), high (≥33) SS groups, p<0.001). By multivariate Cox proportional hazard analysis, SS group was an independent predictor of 3-year POCE (hazard ratio, 1.324; 95% confidence interval, 1.095–1.601; p=0.004). The receiver operating characteristic curves revealed that the SS II was superior to the SS for 3-year POCE prediction (area under the curve [AUC] 0.611 vs. 0.669 for SS vs. SS II, p=0.019), but not for 3-year TLF (AUC 0.631 vs. 0.660 for SS vs. SS II, p=0.996). In subgroup analysis, SS II was superior to SS in patients with cardiovascular clinical risk factors, and in those presenting as stable angina.

CONCLUSIONS:

The usefulness of SS and SS II was still valid in patients with left main and/or 3-vessel disease. SS II was superior to SS for the prediction of patient-oriented outcomes, but not for lesion-oriented outcomes.TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT00698607ClinicalTrials.gov Identifier NCT01605721
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Thoracic Surgery / Stents / Risk Factors / ROC Curve / Taxus / Death / Drug-Eluting Stents / Angina, Stable / Percutaneous Coronary Intervention / Myocardial Infarction Type of study: Etiology study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Korean Circulation Journal Year: 2020 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Thoracic Surgery / Stents / Risk Factors / ROC Curve / Taxus / Death / Drug-Eluting Stents / Angina, Stable / Percutaneous Coronary Intervention / Myocardial Infarction Type of study: Etiology study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Korean Circulation Journal Year: 2020 Type: Article