The CABG SYNTAX Score - an angiographic tool to grade the complexity of coronary disease following coronary artery bypass graft surgery: from the SYNTAX Left Main Angiographic (SYNTAX-LE MANS) substudy

Farooq, Vasim; Girasis, Chrysafios; Magro, Michael; Onuma, Yoshinobu; Morel, Marie Angèle; Heo, Jung Ho; García‐García, Héctor M.; Kappetein, Arie Pieter; Brand, Marcel van den; Holmes, David R.; Mack, Michael J.; Feldman, Ted; Colombo, Antonio; Ståhle, Elisabeth; James, Stefan; Carrié, Didier; Fournial, G; Es, Gerrit Anne van; Dawkins, Keith D.; Mohr, Friedrich W.; Morice, Marie Claude; Serruys, Patrick W.

doi:10.4244/eijv8i11a196

Cited by 209 publications

(251 citation statements)

References 57 publications

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“…All patients selected had undergone coronary angiography during hospitalization. SS analysis is only valid for natural coronary arteries, so patients with previous coronary artery bypass grafts were excluded [9]. Patients with cardiogenic shock were also excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Aktürk¹,

Aşkın²,

Taşolar³

et al. 2018

Med Princ Pract

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Significance of the Study• This study examines the relationship between risk scores and major adverse cardiovascular events (MACE) in patients with non-ST elevation myocardial infarction undergoing percutaneous coronary intervention. All risk scores were able to predict MACE, but the SYNTAX score II (SS-II) was also able to predict in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis. The SS-II scoring system appears to be the most comprehensive scoring system as it is angiographic and has 6 clinical variables. The study population were selected from among 589 patients who underwent coronary angiography with a diagnosis of NSTEMI. TIMI and GRACE risk scores were calculated. SS and SS-II were calculated in all patients, and points were added according to the predefined algorithm, taking into account the other 6 clinical variables being monitored (age, sex, left ventricular ejection fraction, creatinine clearance, chronic obstructive pulmonary disease, and peripheral artery disease). Patients were classified into tertile 1 (SS < 22), tertile 2 (SS 23-32), and tertile 3 (SS > 32). Results: The group with high SS-II for PCI values in the risk scores were observed from tertile 1 to tertile 3 (from 25.0 ± 7.7 to 31.6 ± 9.4, p < 0.001, respectively). The SS-II score in patients with PCI was an independent predictor of MACE, in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis (OR 1.082, 95% CI 1.036-1.131, p < 0.001). The overall MACE, inhospital mortality, and nonfatal myocardial infarction rates

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Section: Methodsmentioning

confidence: 99%

Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Aktürk¹,

Aşkın²,

Taşolar³

et al. 2018

Med Princ Pract

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“…8,20 The CSS has been proposed for evaluating the native coronary atherosclerotic burden and also for assessing the whole myocardial ischemic burden after CABG, which together could predict clinical outcomes in previous CABG surgery patients. 10,11 This study showed the clinical significance of the CSS after repeat revascularization by PCI in previous CABG surgery patients. As shown in Table 1, patients with a high post-PCI CSS had older bypass grafts, higher prevalence of CKD and peripheral artery disease, previous heart failure, lower LVEF, and a higher bCSS compared with those with low scores.…”

Section: Clinical Significance Of the Css Following Pci In Previous Cmentioning

confidence: 99%

“…The CSS was calculated to identify all coronary artery lesions on both the baseline and postprocedural coronary angiograms in accordance with a previous report 10 (Methods section and Figure I in the Data Supplement). The baseline (bCSS) and post-PCI CSS were calculated on the basis of the remaining coronary lesions before and after PCI, respectively.…”

Section: Calculating the Baseline And Post-pci Cssmentioning

confidence: 99%

“…7,8 Moreover, the magnitude of the post-PCI SS, which represents the completeness of coronary revascularization, is associated with the clinical outcomes of patients with CAD after PCI. 9 Recently, the CABG SYNTAX score (CSS) has been proposed as an objective, quantitative measure of coronary anatomic complexity in the setting of CABG surgery, 10 and it was found that patients with a higher CSS had worse clinical outcomes than those with lower scores. 11 However, it is unclear whether the absolute amount of residual CAD after PCI performed as secondary revascularization is associated with clinical outcomes in patients with previous CABG surgery.…”

mentioning

confidence: 99%

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Validation of the Coronary Artery Bypass Graft SYNTAX Score (Synergy Between Percutaneous Coronary Intervention With Taxus) as a Prognostic Marker for Patients With Previous Coronary Artery Bypass Graft Surgery After Percutaneous Coronary Intervention

Miyagi

Asaumi

Nishimura

et al. 2016

Circ: Cardiovascular Interventions

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C oronary artery bypass graft (CABG) surgery has been the standard of care for coronary revascularization. However, during long-term follow-up after initial CABG surgery, patients are at risk of subsequent ischemia because of late graft failures and degeneration of native coronary arteries.2 Regarding repeat coronary revascularization in previous CABG surgery cases, in particular for late failure of saphenous vein grafts, the number of patients referred for percutaneous coronary intervention (PCI) has been increasing. 2,3However, in patients with previous CABG surgery, the optimal revascularization strategy and risk stratification are not yet fully known. 4,5Background-The efficacy and prognosis of percutaneous coronary intervention (PCI) as secondary revascularization in patients with previous coronary artery bypass graft surgery remain uncertain. Methods and Results-We retrospectively evaluated 434 consecutive patients with previous coronary artery bypass graft surgery hospitalized for PCI between 2004 and 2011 (men 84%, age 71 (interquartile range, 66-76) years) and calculated the coronary artery bypass graft Synergy Between Percutaneous Coronary Intervention With Taxus score (CSS) before (baseline CSS) and after PCI (post-PCI CSS). Patients were divided into 2 groups based on median post-PCI CSS: low-score (≤23; n=217) and high-score groups (>23; n=217). Major adverse cardiovascular events (MACE) were defined as the composite of cardiovascular death, myocardial infarction, and unplanned repeat revascularization for myocardial ischemia. The median baseline and post-PCI CSS were 30 (interquartile range, 21-40) and 23 (interquartile range, 14.5-33.5), respectively. During a median follow-up of 69 months, the prevalence of MACE and cardiac death differed significantly between the 2 post-PCI CSS groups (MACE: low, 13.8%; high, 28.6%; P<0.001; cardiac death: low, 6.2%; high, 16.7%; P=0.002). In multivariable analysis, the high post-PCI CSS divided by the median was associated with substantially greater cumulative MACE (hazard ratio, 2.09; 95% confidence interval, 1.31-3.34; P=0.002) and cardiac death (hazard ratio, 2.02; 95% confidence interval, 1.03-3.98; P=0.042) compared with the low post-PCI CSS. Net reclassification improvement analysis revealed that post-PCI CSS resulted in significantly improved prediction of MACE and cardiac death compared with baseline CSS. Conclusions-In this external validation study, the CSS was a potential prognostic factor after subsequent PCI, even for previous coronary artery bypass graft surgery patients. (Circ Cardiovasc Interv. 2016;9:e003459.

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“…38 Essentially, it is the SYNTAX score of the native coronary vessels with points deducted based on the vessel-segment weighting of the bypassed coronary vessel. In such a way, it allows for a feasible and plausible calculation of the SYNTAX score in patients with prior CABG, and for the incorporation of CABG patients into contemporary trials measuring coronary complexity.…”

Section: The Syntax Score: Strengths and Weaknessesmentioning

confidence: 99%

Beyond the SYNTAX Score

Capodanno

2013

Circ J

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The CABG SYNTAX Score - an angiographic tool to grade the complexity of coronary disease following coronary artery bypass graft surgery: from the SYNTAX Left Main Angiographic (SYNTAX-LE MANS) substudy

Abstract: In this pilot study the calculation of the CABG SXscore appeared feasible, reproducible and may have a long-term prognostic role in patients with complex coronary disease undergoing surgical revascularisation. Validation of this new scoring methodology is required.

Cited by 209 publications

References 57 publications

Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Validation of the Coronary Artery Bypass Graft SYNTAX Score (Synergy Between Percutaneous Coronary Intervention With Taxus) as a Prognostic Marker for Patients With Previous Coronary Artery Bypass Graft Surgery After Percutaneous Coronary Intervention

Beyond the SYNTAX Score

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