Prognostic impact of residual SYNTAX score in patients with obstructive sleep apnea and acute coronary syndrome: a prospective cohort study

Zeng, Yaping; Yang, Shuhan; Wang, Xiao; Fan, Jingyao; Nie, Shaoping; Wei, Yongxiang

doi:10.1186/s12931-019-1008-z

Cited by 13 publications

(14 citation statements)

References 33 publications

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“…We recommend that all patients with MVCAD undergoing PCI should undergo a functional assessment of the residual lesions even though they appear as anatomically significant that would translate into good clinical outcomes, which was proved in chronic kidney disease as well as obstructive sleep apnea patients also. 36 However, further studies are needed to assess the anatomic versus the functional residual burden of residual coronary atherosclerosis that further helps in prognostication.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Residual Syntax Score after Percutaneous Coronary Intervention in Multivessel Coronary Artery Disease

Aramalla¹,

Garre²,

Shaik³

et al. 2019

Ind J Car Dis Wom

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Background Residual SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Score (RSS) is an objective measure for the assessment of degree and complexity of residual stenosis after the percutaneous coronary intervention (PCI). Aim The study aimed at evaluating the role of angiographic complete (CR) and incomplete (ICR) revascularization on clinical outcomes in patients undergoing PCI for multivessel coronary artery disease (MVCAD). The study sought to investigate the role of initial and residual severity of coronary atherosclerosis in prognostication of patients with MVCAD who underwent PCI. Material and Methods We retrospectively recruited 135 patients having MVCAD who underwent PCI. Coronary angiogram was used to assess the severity of coronary atherosclerosis. From the angiographic data baseline (BSS) and RSS were calculated. Subjects having a RSS of 0 were defined as having CR, and those having RSS > 0 are defined as ICR group. The study population was subgrouped into two groups as follows: CR, 0 (n = 17, 23%); ICR, >0 to 4 (n = 89, 47.2%). Clinical outcomes were measured, which included major adverse cardiac and cerebrovascular events (MACE) at 1 year. Results Among the study subjects mean age was 57.25 ± 17.55. About 76.3% were males, and 23.7% were females. About 89.4% had diabetes, 88.6% had hypertension as risk factors, and 95.8% were smokers. The mean values of BSS and RSS were 20.2 ± 9.2 and 4.1 ± 7.0, respectively. Based on RSS the individuals were divided into two groups as follows: CR, 0 (n = 17, 23%); ICR, > 0 to 4 (n = 89, 47.2%), > 4 to 8 (n = 16, 21.6%), > 8 (n = 13, 17.55%). After 1 year, three patients lost the follow-up. Among the remaining 132 patients, those with higher BSS had more mortality and morbidity, and the difference is statistically significant (MACE in ≥23 vs. <23, p = 0.000755); 10 patients in the ICR group had MACE compared with 1 patient in CR group(5.8% in CR group vs. 8.6% in ICR group, p-value of 0.38); however, the difference was not statistically significant. However, higher RSS acts as an indirect marker of increasing morbidity and mortality when compared within the tertiles, and the difference was statistically significant (RSS 1-4 group vs. > 4 MACE, p = 0.0009559, RSS < 8 vs. >8 MACE, p = 0.00000172). Conclusions This study proved that both BSS and higher RSS help to foretell the risk of adverse clinical outcomes in individuals with MVCAD who underwent PCI. RSS, which is an indirect marker of residual atherosclerosis, that is, ICR, had a positive correlation MACE after PCI. AbstractKeywords ► residual SYNTAX Score (RSS) ► multivessel coronary artery disease (MVCAD) ► complete revascularization (CR) ► incomplete revascularization (ICR)

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Residual Syntax Score after Percutaneous Coronary Intervention in Multivessel Coronary Artery Disease

Aramalla¹,

Garre²,

Shaik³

et al. 2019

Ind J Car Dis Wom

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“…According to the syntax score, the patients were assigned into three groups: high-risk group (syntax score > 32), intermediaterisk group (syntax score of 22 to 32), and low-risk group (syntax score < 22). Involved vessels, including the left anterior descending artery, Right Coronary Artery (RCA), Left Circumflex Artery (LCX), and the left main stem, were also determined (6,18,19). This study was approved by the Ethics Committee of Guilan University of Medical Sciences (no.IR.GUMS.REC.1397.388).…”

Section: Methodsmentioning

confidence: 99%

“…The SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score is a grading system to evaluate the complexity and prognosis of patients undergoing percutaneous coronary intervention (6). It is a tool to select revascularization strategies and is obtained based on 11 angiography variables that consider the location and properties of lesions.…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic Changes and Coronary Findings in Patients with Acute non-ST-Elevation Myocardial Infarction: A Cross-Sectional Study

Mirbolouk

Salari

Riahini

et al. 2020

Jundishapur J Chronic Dis Care

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Background: Despite significant improvements in diagnosis and treatment, non-ST-Elevation Myocardial Infarction (NSTEMI) is still one of the health problems in developed and developing countries. Objectives: The present study was performed to assess the electrocardiographic changes and coronary findings in patients with NSTEMI. Methods: The study enrolled 158 patients with NSTEMI diagnosis at the discharge time. Demographic characteristics and electrocardiographic changes were collected using a checklist from the medical records of the patients. The angiography data were used to calculate a syntax score for each patient. Finally, patients were divided into three groups based on this score: high risk >32, intermediate risk 22-32, and low risk < 22. Involved vessels, including the left anterior descending artery, Right Coronary Artery (RCA), Left Circumflex Artery (LCX), and the left main stem, were also determined. Results: The mean age of the patients was 60.68 ± 12.15 years. The LAD, LCX, and RCA were the most common involved vessels, in sequence. About 27.73, 67.15, and 5.12% of the patients were assigned to low, moderate, and high-risk groups, respectively. Statistically significant differences were observed in the frequencies of ECG changes (P = 0.003) and types of involved vessels (P < 0.001) between low, moderate, and high-risk patients. In addition, there were statistically significant differences in the mean syntax scores between different types of involved vessels (P < 0.001). Conclusions: The findings of the present study showed a significant relationship between the types of vessel involvement and syntax score. Also, there was a high prevalence of ST changes in precordial leads that may improve the sensitivity of diagnosis. We did not find any significant relationship between the frequencies of ECG changes based on the types of involved vessels.

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“…Sixteen studies reported an increased Hazard ratio (HR) of MACCEs outcomes with SDB compared with controls in patients with myocardial ischemia, 12,13,16,18,19,20,21,22,23,24,25,26,27,28,29,30 with the combined HR of 1.66(95% CI 1.41-1.94, P< 0.0001) (Fig 2). Some evidence of statistical heterogeneity (Cochran Q = 23.00, p=0.08; I 2 = 35%) was found by pooled effect size, which might be in part attributable to 1 randomized controlled trial.…”

Section: Major Adverse Cardiovascular or Cerebrovascular Events (Macces)mentioning

confidence: 99%

Association of Sleep-Disordered Breathing With Cardiovascular Events and Death in patients With Ischemic Heart Disease: A systematic review and meta-analysis

Zhang

Tan

Miao

et al. 2021

Preprint

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Objective Previous studies have identified that sleep-disordered breathing is associated with the increased risk of cardiovascular disease. However, CPAP, the preferred treatment of sleep apnea, does not appear to reduce the risk of adverse cardiovascular events and deaths in ischemic heart disease. Our aim was to determine whether OSA can be a prognostic factor for cardiovascular adverse events and deaths in patients with ischemia heart disease. Methods We searched Medline via PubMed, Embase, and the Cochrane Library database for clinical studies reporting the major adverse cardiac outcomes of SDB in patients with myocardial ischemia. Sleep apnea tests is mainly performed with cardiorespiratory polygraphy or portable diagnostic device. Summary hazard ratio(HR) and 95% CIs were conducted using random-effects meta-analysis. Results Eighteen literatures were included, with total participants of 9,138. Sixteen studies reported MACCEs, there was significant association of SDB with MACCES (HR, 1.66[95% CI, 1.41 to 1.94]; P< 0.0001), all-cause mortality (HR, 1.39[95% CI 1.12 to 1.73], P=0.0027) and cardiovascular mortality (HR, 2.12[95% CI 1.23 to 3.65], P=0.007). Subgroup analysis showed that one study was the cause of heterogeneity, while no correlation between SDB and outcomes for sleep apnea severity, follow-up time or whether surgery was performed. Conclusion SDB is associated with adverse cardiac outcomes in patients with ischemic heart disease, suggesting that sleep apnea can be screened for patients with ischemic heart disease, which can be used as a clinically relevant strategy of secondary prevention to reduce the risk of adverse outcomes.

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Prognostic impact of residual SYNTAX score in patients with obstructive sleep apnea and acute coronary syndrome: a prospective cohort study

Cited by 13 publications

References 33 publications

Prognostic Value of Residual Syntax Score after Percutaneous Coronary Intervention in Multivessel Coronary Artery Disease

Prognostic Value of Residual Syntax Score after Percutaneous Coronary Intervention in Multivessel Coronary Artery Disease

Electrocardiographic Changes and Coronary Findings in Patients with Acute non-ST-Elevation Myocardial Infarction: A Cross-Sectional Study

Association of Sleep-Disordered Breathing With Cardiovascular Events and Death in patients With Ischemic Heart Disease: A systematic review and meta-analysis

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