A New Tool for the Risk Stratification of Patients With Complex Coronary Artery Disease: The Clinical Syntax Score

Garg, Scot; Sarno, Giovanna; Girasis, Chrysafios; García‐García, Héctor M.; Wykrzykowska, Joanna J.; Dawkins, Keith D.; Serruys, Patrick W.

doi:10.1016/s0735-1097(10)61861-x

Cited by 87 publications

(162 citation statements)

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“…Risk score calculation Logistic EuroSCORE, SYNTAX score, clinical SYNTAX score (CSS), and EuroHeart PCI score were calculated in all patients as reported elsewhere [15,17,19,20]. The SYNTAX score which derives from the summation of the individual scorings for each separate lesion has been calculated by two independent cardiologists who were blinded to procedural and outcome data.…”

Section: Study Endpoint Data Collection and Follow-upmentioning

confidence: 99%

“…A model combining clinical and angiographic-based scores can assess completely different, but equally important variables and, thus, provide a more complete evaluation of the procedure-related risk [22]. Garg et al [15] added the age, creatinine, ejection fraction (ACEF) score to the angiographic SYNTAX score: this so-called CSS showed superior discriminative ability at 5-year follow-up among patients with complex coronary artery disease.…”

Section: Combined Risk Scoresmentioning

confidence: 99%

“…The aims of our study were: (1) to assess the prognostic value of angiographic characteristics represented by the SYNTAX score versus clinical variables represented by the EuroSCORE for the prediction of major adverse cardiac events (MACE) in patients after ULMCA-PCI in a ''realworld'' setting, (2) to develop a combined risk model for daily practice, and (3) to compare this combined risk model including angiographic and clinical characteristics to the recently published risk scores [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

et al. 2012

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Section: Study Endpoint Data Collection and Follow-upmentioning

confidence: 99%

Section: Combined Risk Scoresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

et al. 2012

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“…Among patients with multivessel coronary artery disease, patients with a low CSS (B15.6) had significantly higher 1-year and 5-year mortality and major adverse cardiovascular and cerebrovascular events (MACCE; death, cerebrovascular accident, any revascularization and MI) compared to patients with a high CSS ([27.5). The c-statistic for CSS was 0.69 for 5 year mortality and 0.62 for 5-year MACCE whereas the c-scores for the SYNTAX score for 5-year mortality and MACCE were 0.62 and 0.59 respectively [46]. Thus, the addition of clinical characteristics improved the predictive power of the SYNTAX score.…”

Section: Bc-pci Risk Scorementioning

confidence: 91%

“…The Clinical SYNTAX Score (CSS) combines the complex angiographic SYNTAX scoring system with the clinical characteristics of age, left ventricular ejection fraction and creatinine clearance [46]. The ACEF (age, creatinine and left ventricular ejection fraction) score was initially created to access mortality risk in patients undergoing cardiac surgery.…”

Section: Bc-pci Risk Scorementioning

confidence: 99%

Novel QCA methodologies and angiographic scores

Lansky

2011

Int J Cardiovasc Imaging

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Coronary angiography remains the gold-standard method for evaluating coronary artery disease and interventional treatments. As percutaneous coronary interventions have advanced, quantitative coronary angiography (QCA) techniques have also evolved in order to provide more accurate assessments of these therapies. Improvements have been made at each step of the QCA process from image acquisition to vessel analysis. In addition, multiple scoring systems have been developed in order to utilize QCA data, both alone and in conjunction with clinical factors, to better stratify patient risk. This article will review the recent advancements in QCA techniques and outcome prediction models.

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Percutaneous coronary intervention of unprotected left main coronary artery disease

Lee¹,

Stone²,

Park³

et al. 2011

Cathet Cardio Intervent

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Data have emerged demonstrating the safety and efficacy of percutaneous coronary intervention (PCI) of the unprotected left main (ULM) artery. The 2009 American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions focused guidelines for PCI no longer state that ULM PCI is contraindicated in patients with anatomic conditions that are associated with a low risk of procedural complications and clinical conditions that predict an increased risk of adverse surgical outcomes. ULM PCI should be performed by operators with experience in the management of the anatomic complexities of left main and multivessel disease, specifically in issues relating to bifurcation disease, calcification, and hemodynamic support. Patients with ostial or shaft disease have lower risk of restenosis compared with distal bifurcation disease. Drug-eluting stents (DES) should be used whenever possible as they reduce clinical restenosis. Intravascular ultrasound is an integral component of the procedure as it provides accurate assessment of lesion severity and can confirm optimal stent expansion and apposition. Compliance with dual antiplatelet therapy for at least 12 months is essential if DES are used. A collaborative, multidisciplinary approach with a "Heart Team" represented by a cardiac surgeon, interventional cardiologist, and non-invasive cardiologist may optimize patient education and objective decision making when obtaining informed consent. Application of clinical and angiographic variables into risk models facilitates appropriate patient selection. Randomized clinical trials will address unanswered issues and help build consensus between cardiology and surgical societies to inform clinical decision making and optimize the outcomes for patients with ULM coronary artery disease.

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A New Tool for the Risk Stratification of Patients With Complex Coronary Artery Disease: The Clinical Syntax Score

Cited by 87 publications

References 0 publications

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

Novel QCA methodologies and angiographic scores

Percutaneous coronary intervention of unprotected left main coronary artery disease

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