Prevalence rates of hypertension differed a lot in the campaign sample and in the representative population sample, showing that the sampling criterion may influence assessment of risk factors and bias the association between risk factors and health aggravations.
Background:The importance of coronary anatomy in predicting cardiovascular events is
well known. The use of traditional anatomical scores in routine angiography,
however, has not been incorporated to clinical practice. SYNTAX score
(SXscore) is a scoring system that estimates the anatomical extent of
coronary artery disease (CAD). Its ability to predict outcomes based on a
baseline diagnostic angiography has not been tested to date.Objective:To evaluate the performance of the SXscore in predicting major adverse
cardiac events (MACE) in patients referred for diagnostic angiography.Methods:Prospective cohort of 895 patients with suspected CAD referred for elective
diagnostic coronary angiography from 2008 to 2011, at a
university-affiliated hospital in Brazil. They had their SXscores calculated
and were stratified in three categories: no significant CAD (n = 495),
SXscoreLOW-INTERMEDIATE: < 23 (n = 346), and
SXscoreHIGH: ≥ 23 (n = 54). Primary outcome was a
composite of cardiac death, myocardial infarction, and late
revascularization. Secondary endpoints were the components of MACE and death
from any cause.Results:On average, patients were followed up for 1.8 ± 1.4 years. The primary
outcome occurred in 2.2%, 15.3%, and 20.4% in groups with no significant
CAD, SXscoreLOW-INTERMEDIATE, and SXscoreHIGH,
respectively (p < 0.001). All-cause death was significantly higher in the
SXscoreHIGH compared with the 'no significant CAD' group,
16.7% and 3.8% (p < 0.001), respectively. After adjustment for
confounding factors, all outcomes remained associated with the SXscore.Conclusions:SXscore independently predicts MACE in patients submitted to diagnostic
coronary angiography. Its routine use in this setting could identify
patients with worse prognosis.
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