A Patient-Level Pooled Analysis Assessing the Impact of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) Score on 1-Year Clinical Outcomes in 6,508 Patients Enrolled in Contemporary Coronary Stent Trials

Garg, Scot; Sarno, Giovanna; Girasis, Chrysafios; Vranckx, Pascal; Vries, Ton de; Swart, Michael; Bressers, Marco; García‐García, Héctor M.; Es, Gerrit‐Anne van; Räber, Lorenz; Campo, Gianluca; Valgimigli, Marco; Dawkins, Keith D.; Windecker, Stephan; Serruys, Patrick W.

doi:10.1016/j.jcin.2011.02.018

Cited by 78 publications

(54 citation statements)

References 32 publications

(81 reference statements)

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“…In the event of disagreement, the opinion of a third analyst was sought, and the final decision was established by consensus. As previously described 17,[22][23][24] , patients with occluded infarct-related arteries were scored as having occlusions of unknown duration in a similar manner to any chronically occluded artery. In addition, those patients with lesions due to restenosis were scored in the same manner as de novo lesions.…”

Section: Definitionsmentioning

confidence: 99%

“…Patients presenting with ACS are currently considered to be at high risk of major adverse cardiac events (MACE) during short-and long-term followup, and therefore receive aggressive pharmacotherapy 15 . However, patients with stable ischaemic heart disease (SIHD) include a broad spectrum of anatomic disease complexity, which -as assessed by the SYNTAX score -has been shown to be predictive of outcomes [16][17][18] . To date, no data are available comparing outcomes after PCI between patients with ACS and stable CAD stratified by anatomic disease complexity.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcome of patients with stable ischaemic heart disease as compared to those with acute coronary syndromes after percutaneous coronary intervention

Vranckx

Kalesan²,

Farooq³

et al. 2015

EuroIntervention

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Aims: To compare clinical outcomes after percutaneous coronary intervention (PCI) between patients with acute coronary syndromes (ACS) and those with stable ischaemic heart disease (SIHD) stratified by anatomic disease complexity (SYNTAX score).Methods and results: Patient-level data from three all-comers PCI trials were pooled. Patients (n=4,204) were stratified by clinical presentation (i.e., ACS or SIHD) and by SYNTAX score (i.e., lowest vs. two highest tertiles). The major adverse cardiac event (MACE) rates of patients with low-risk SIHD (n=531) and high-risk SIHD (n=1,066) were compared with ACS patients (n=2,607), respectively. At two years, the risk of MACE was higher for high-risk SIHD patients (OR 1.34, 95% CI: 1.08-1.66) and lower for low-risk SIHD patients (OR 0.61, 95% CI: 0.43-0.87) compared with ACS patients, respectively. This difference between high-risk SIHD patients and ACS patients was primarily driven by a higher risk of myocardial infarction (OR 1.64, 95% CI: 1.21-2.21), while there was no difference for cardiac death (OR 0.77, 95% CI: 0.49-1.21) or target lesion revascularisation (OR 1.21, 95% CI: 0.91-1.62).

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Section: Definitionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical outcome of patients with stable ischaemic heart disease as compared to those with acute coronary syndromes after percutaneous coronary intervention

Vranckx

Kalesan²,

Farooq³

et al. 2015

EuroIntervention

Self Cite

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“…In this regard, the anatomical SS has been consistently shown to be an important tool for risk stratification. 1,[13][14][15][16][17][18] However, one of the most significant limitations of the SS is the omission of clinical variables in its calculation, which has been identified as a major effect in its capacity to accurately stratify patients with complex CAD. [19][20][21] The SS-II, by incorporating both the anatomic SS and clinical variables theoretically ensures a more accurate and individualized clinical outcome prediction.…”

Section: Discussionmentioning

confidence: 99%

SYNTAX Score-II Predicts Long-Term Mortality in Patients Who Underwent Left Main Percutaneous Coronary Intervention Treated With Second-Generation Drug-Eluting Stents

Zhao

et al. 2017

Int. Heart J.

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SummaryThe aim of this study was to evaluate the capacity of the SYNTAX Score-II (SS-II) to predict long-term mortality in patients undergoing left main percutaneous coronary intervention (LM-PCI) treated with second-generation drug-eluting stents (DES).Data from 487 consecutive patients with de novo left main coronary artery disease undergoing PCI were retrospectively studied. The patients were divided into tertiles according to the SS-II: low SS-II tertile (SS-II ≤ 22), intermediate SS-II tertile (SS-II of 23 to 30), and high SS-II tertile (SS-II ≥ 30). The survival curves were estimated by the KaplanMeier method. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the possible associations between the SS-II and the rates of long-term mortality. The predictive ability of the SS-II for mortality was assessed and compared with the SYNTAX score (SS) alone by an area under the receiver operator curve (AUC).The overall SS-II was 27.3 ± 9.1. At a mean follow-up of 5.1 years, the long-term mortality was 6.0%. The rates of mortality were 2.4%, 3.4%, and 11.6%, respectively (P < 0.0001) in the low, intermediate, and high SS-II tertiles. The cardiac mortality rates were 1.8%, 1.4%, and 8.1%, respectively (P = 0.002) among patients in the 3 groups. By multivariate analysis, SS-II was an independent predictor of the long-term mortality (hazard ratio: 1.56, 95% confidence interval: 1.05 to 2.32; P = 0.03). The AUC demonstrated a substantially higher predictive accuracy of the SS-II for mortality compared with the SS alone (AUC was 0.689 and 0.596, respectively).In patients with LM-PCI treated with a second-generation DES, the SS-II is an independent predictor of long-term mortality and demonstrates a superior predictability compared with the SS alone. (Int Heart J 2017; 58: 344-350) Key words: Left main coronary artery disease, Predict T he SYNTAX score II (SS-II) was recently developed by applying a Cox proportional hazards model to the results of the SYNTAX trial data. The SS-II incorporates a combination of two anatomical (anatomical SS and left main coronary artery disease) and 6 clinical variables (age, sex, left ventricular ejection fraction, creatinine clearance, chronic obstructive pulmonary disease, and peripheral vascular disease).1) The SS-II has been shown to provide reliable predictions of 4-year mortality for complex coronary artery disease (CAD), being internally validated in the landmark, all-comers, randomized SYNTAX trial 1,2) and externally applied in two real world registries.3,4) Therefore, the SS-II provides an impartial, evidence-based assessment of the decision-making process for clinicians weighing anatomical and clinical factors to establish the optimum revascularization technique for individual patients with complex CAD. However, all previous studies [1][2][3][4][5] about the validation of the SS-II have enrolled patients totally or mostly treated with a first-generation DES and some even used a small number of bare metal stents. At present, secon...

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“…Так, крупный метаана-лиз 7 исследований, вклю-чивший в общей сложно-сти 6 508 больных [10], вполне убедительно пока-зал, что индекс Syntax явля-ется предиктором таких событий, как смерть, ин-фаркт миокарда, тромбоз стента и повторная реваскуляризация коронарных артерий у па-циентов, которым выполнялось ЧКВ. Важной особенностью этого метаанализа являлось то обстоятельство, что в него, так же как и в на-шем исследовании, в основном вошли пациен-ты с невысоким значением индекса Syntax (16,7 ± 11,1 балла в сравнении с 13,3 ± 7,7 бал-ла в нашем исследовании), индекс более 32 баллов имели не более 10% пациентов.…”

Section: Discussionunclassified

“…доля пациентов с ОКС пре-РИСУНОК 5. Частота ССО в группах больных, сформированных в зависимости от уровня Д-димера и индекса Syntax II вышала 50% [10]. Выборочная информатив-ность шкалы Syntax в отношении предсказа-ния риска смерти у пациентов после ЧКВ и ИМ с подъемом сегмента ST (но не со стабильной ИБС) была продемонстрирована в исследова-нии C.M.…”

Section: Discussionunclassified

Is the Syntax Score Sufficient to Assess the Risk for Patients Undergoing Elective Percutaneous Coronary Interventions?

Новикова¹,

Комаров²,

Гуськова³

et al. 2017

Aterotromboz

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A Patient-Level Pooled Analysis Assessing the Impact of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) Score on 1-Year Clinical Outcomes in 6,508 Patients Enrolled in Contemporary Coronary Stent Trials

Abstract: This study confirms the consistent ability of the SXscore to identify patients who are at highest risk of adverse events.

Cited by 78 publications

References 32 publications

Clinical outcome of patients with stable ischaemic heart disease as compared to those with acute coronary syndromes after percutaneous coronary intervention

Clinical outcome of patients with stable ischaemic heart disease as compared to those with acute coronary syndromes after percutaneous coronary intervention

SYNTAX Score-II Predicts Long-Term Mortality in Patients Who Underwent Left Main Percutaneous Coronary Intervention Treated With Second-Generation Drug-Eluting Stents

Is the Syntax Score Sufficient to Assess the Risk for Patients Undergoing Elective Percutaneous Coronary Interventions?

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