Usefulness of the updated logistic clinical <scp>SYNTAX</scp> score after percutaneous coronary intervention in patients with prior coronary artery bypass graft surgery: Insights from the <scp>GLOBAL LEADERS</scp> trial

Hara, Hironori; Kogame, Norihiro; Takahashi, Kuniaki; Modolo, Rodrigo; Chichareon, Ply; Tomaniak, Mariusz; Ono, Masafumi; Kawashima, Hideyuki; Gao, Chao; Wang, Rutao; Valkov, Veselin; Dahl, Juergen vom; Steinwender, Clemens; Geisler, Tobias; Neto, Pedro Alves Lemos; Miguel, Carlos Macaya; Garg, Scot; Jüni, Peter; Hamm, Christian W.; Steg, Philippe Gabríel; Valgimigli, Marco; Vranckx, Pascal; Windecker, Stephan; Farooq, Vasim; Onuma, Yoshinobu; Serruys, Patrick W.

doi:10.1002/ccd.28898

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…Multiple risk-prediction models have been proposed for predicting post-MI bleeding and mortality outcomes, including clinical, angiographic, or combined scoring systems [25][26][27]. The ACEF score was first developed to predict the endpoints of patients undergoing bypass surgery [6].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy

Ösken¹,

Hacı²,

Şekerci³

et al. 2021

pwki

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Introduction: In patients who have undergone interventional cardiac procedures, the risk of bleeding is higher than in patients who received conservative treatment due to multiple medications and comorbidities.Aim: This study aimed to evaluate the usefulness of the age, creatinine and ejection fraction (ACEF) score for predicting bleeding events and to compare short-and long-term clinical outcomes according to the ACEF score in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) with bail-out tirofiban therapy (BOTT).Material and methods: A total of 2,543 patients were included and divided into three groups according to the following ACEF score tertiles: T1 (ACEF low ≤ 1.033), T2 (1.033 < ACEF mid ≤ 1.371), and T3 (ACEF high > 1.371). The main outcomes measured were the incidence rates of relevant bleeding events and mortality within 30 days and 3 years after the procedure.Results: A total of 73 (2.9%) patients had Bleeding Academic Research Consortium bleeding events of grades 3, 4 or 5 and 104 (4%) patients died in a 30-day period. The ACEF score was effective at predicting 30-day bleeding (area under the receiver operating characteristic curve (AUC): 0.658, 95% confidence interval (CI): 0.579-0.737; p < 0.001), 30-day mortality (AUC = 0.701, 95% CI: 0.649-0.753; p < 0.001) and 3-year mortality (AUC = 0.778, 95% CI: 0.748-0.807; p < 0.001) events. Considering the ACEF score tertiles, T3 patients presented greater 30-day bleeding (1.

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Section: Discussionmentioning

confidence: 99%

Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy

Ösken¹,

Hacı²,

Şekerci³

et al. 2021

pwki

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“…Takahashi et al have demonstrated that the newly developed SS-II 2020, which predicts 10-year mortality and 5-year MACE, may be useful in patients selected for CABG or PCI, thus allowing for the best revascularization strategy [34]. Hara et al have observed that the logistic clinical SS outperforms the anatomical CABG SS in predicting 2-year mortality [35].…”

Section: Recent Studiesmentioning

confidence: 99%

The Clinical Value of Syntax Scores in Predicting Coronary Artery Disease Outcomes

Aşkın

2022

CVIA

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The Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (SS) hassignificantly improved angiographic risk stratification. By analyzing angiographic variables, this score characterizescoronary artery disease qualitatively and quantitatively. To date, combining this score with other non-angiographic clinicalscores has broadened perspectives regarding risk estimation, and future research on this topic appears promising.

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“…Only the impact of CrCl was evaluated in the development of the SYNTAX score II 2020, although preprocedural biological markers, such as haemoglobin, white blood cells (WBC), C-reactive protein (CRP), and brain natriuretic peptide have been reported in the literature to be associated with outcomes after revascularisation [3][4][5][6] . Of note, the logistic clinical SYNTAX score was developed, validated and updated to enable a more accurate prediction of mortality after PCI; the incorporation of biological markers (haemoglobin and WBC) has improved the predictivity [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial

Hara¹,

Kawashima²,

Ono³

et al. 2022

EuroIntervention

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Background: Creatinine clearance (CrCl) is an independent determinant of mortality in predictive models of revascularisation outcomes for complex coronary artery disease.Aims: This study aimed to investigate the impact of preprocedural biological markers on 10-year mortality following coronary revascularisation. Methods:The SYNTAX Extended Survival (SYNTAXES) study evaluated the 10-year vital status followup of 1,800 patients with de novo three-vessel (3VD) and/or left main coronary artery disease (LMCAD) randomised to include percutaneous or surgical coronary revascularisation. The associations between mortality and preprocedural C-reactive protein (CRP), haemoglobin, HbA1c, CrCl, fasting triglycerides, lowdensity lipoprotein cholesterol, and high-density lipoprotein cholesterol were analysed.Results: Out of 1,800 patients, 460 patients died before the 10-year follow-up. CRP, HbA1c and CrCl with threshold values of ≥2 mg/L, ≥6% (42 mmol/mol) and <60 ml/min, respectively, were associated with 10-year all-cause death (adjusted hazard ratio [95% confidence interval]: 1.35 [1.01-1.82], 1.51 [1.16-1.95], and 1.46 [1.07-2.00], respectively). There was no significant interaction between the biological markers on all-cause mortality and the type of revascularisation. Preprocedural lipid markers were not significantly associated with 10-year all-cause death, but the non-use of statins was a determinant factor of worse prognosis (adjusted hazard ratio [95% confidence interval]: 1.68 [1.26-2.25]). Conclusions:Preprocedural biomarkers, such as CRP and HbA1c, are associated with long-term mortality post revascularisation, regardless of the revascularisation technique. Conventional lipidic biomarkers associated with high-risk of cardiovascular events seem to be effectively mitigated by the long-term use of statins, whereas the non-use of statins was a factor of a worse prognosis, emphasising the importance of pharmacological treatment. Trial registration: SYNTAXES ClinicalTrials.gov: NCT03417050. SYNTAX ClinicalTrials.gov: NCT00114972.

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Usefulness of the updated logistic clinical SYNTAX score after percutaneous coronary intervention in patients with prior coronary artery bypass graft surgery: Insights from the GLOBAL LEADERS trial

Cited by 5 publications

References 34 publications

Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy

Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy

The Clinical Value of Syntax Scores in Predicting Coronary Artery Disease Outcomes

Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial

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