Worse clinical outcomes following percutaneous coronary intervention with a high SYNTAX score

Bundhun, Pravesh Kumar; Bhurtu, Akash; Huang, Feng

doi:10.1097/md.0000000000007140

Cited by 19 publications

(18 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[17] The SYNTAX score was seldom being used as a prognostic tool in Interventional cardiology. However, newer scientific reports have shown its importance in Interventional cardiology as well, [18,19] but the fact that it also has limitations when compared with newer tools, we were compelled to further consider other tools. [20]…”

Section: Discussionmentioning

confidence: 99%

Use of the SYNTAX Score II to predict mortality in interventional cardiology

Yang¹,

Zhang

Xu³

2019

Medicine

View full text Add to dashboard Cite

Background:As the SYNTAX Score has limitations, it should be replaced by another better angiographic tool. By comparing mortality that was observed following percutaneous coronary intervention (PCI) in patients who were allotted a low versus a high score, we aimed to systematically investigate mortality prediction using the SYNTAX Score II in Interventional Cardiology.Methods:Electronic databases were searched for relevant publications using the terms “SYNTAX Score II and percutaneous coronary intervention.” The main outcome was all-cause mortality. This analysis was carried out by the RevMan 5.3 software [risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated].Results:A total number of 9443 participants were enrolled for this analysis. As different studies reported different range of SYNTAX Score II, we further classified these scores range into 4 different groups: 17 < SS > 17, 20 < SS > 20, 22 < SS > 22, and 26 < SS > 26 appropriately. Results of this analysis showed that the risk of mortality in patients with a high SYNTAX Score II (SS > 17) was significantly higher (RR: 2.65, 95% CI: 1.05–6.73; P = .04) than patients with a low SYNTAX Score II (SS < 17). Even when participants with a low SYNTAX Score II (SS < 20) were compared with patients who were assigned to a higher SYNTAX Score II (SS > 20), a significantly higher risk of mortality was associated with a high SYNTAX Score II (RR: 3.73, 95% CI: 1.99 – 6.96; P = .0001).Conclusion:Following PCI, the risk of mortality was higher in those patients with a high SYNTAX Score II. The SYNTAX Score II might be considered as an important tool to predict mortality in Interventional Cardiology. Future research should further explore the benefits of this tool.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of the SYNTAX Score II to predict mortality in interventional cardiology

Yang¹,

Zhang

Xu³

2019

Medicine

View full text Add to dashboard Cite

show abstract

“…A high risk of restenosis was observed in patients with DM who underwent PCI, which may be associated with the need for more than two stents in MVD, as well as the continuous progression of diffuse atherosclerosis in non-culprit vessels [39]. At present, it is recommended to apply SYNTAX scores to the selection of revascularization strategies [40, 41]. Although the SYNTAX score might be considered useful in interventional cardiology, it has some limitations [42].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studies

Zhai

Cong

Hou

et al. 2019

Diabetol Metab Syndr

View full text Add to dashboard Cite

BackgroundThe optimal revascularization technique in diabetic patients with complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD), remains controversial. The current study aimed to compare adverse clinical endpoints of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM).MethodsRelevant studies were found from MEDLINE, OVID, Science Direct, Embase and the Cochrane Central database from January 2010 to April 2019. Risk ratio (RR) with 95% confidence interval (CI) was used to express the pooled effect on discontinuous variables. Outcomes evaluated were all-cause mortality, major adverse cardiac/cerebrovascular events (MACCE), cardiac death, myocardial infarction, stroke, and repeat revascularization.ResultsSixteen studies were included (18,224 patients). PCI was associated with the increase risk for MACCE (RR 1.59, 95% CI 1.38–1.85), cardiac death (RR 1.76, 95% CI 1.11–2.80), MI (RR 1.98, 95% CI 1.53–2.57), repeat revascularization (RR 2.61, 95% CI 2.08–3.29). The risks for all-cause mortality (RR 1.23, 95% CI 1.00–1.52) and stroke (RR 0.71, 95% CI 0.48–1.03) were similar between two strategies. Stratified analysis based on studies design and duration of follow-up showed largely similar findings with the overall analyses, except for a significant increased risk of all-cause mortality (RR 1.32, 95% CI 1.04–1.67) in long-term group, and CABG was associated with a higher stroke rate compared to PCI, which are results that were found in RCTs (RR 0.47, 95% CI 0.28–0.79) and mid-term groups (RR 0.39, 95% CI 0.23–0.66).ConclusionsCABG was superior to PCI for diabetic patients with complex CAD (including left main CAD and/or MVD), but might be associated with a higher risk of stroke mid-term follow-up.Number of Protocol registration PROSPERO CRD 42019138505.

show abstract

“…SYNTAX score is a tool to select revascularization strategies while Gensini score is a quick way to qualified the coronary stenosis. [ 29 , 30 ] In this study, we used Gensini score to investigate the association between coronary dominance and CAD and found that RD group prone to have high Gensini score than those with LD and CD. Many previous studies have shown that an LD system is predictive for the prognosis of patients with coronary emergencies.…”

Section: Discussionmentioning

confidence: 99%

Impact of right coronary dominance on triple-vessel coronary artery disease

Peng

Guo

Gao³

et al. 2018

Medicine

View full text Add to dashboard Cite

This study was conducted to investigate the relationship between right coronary dominance and coronary angiographic characteristics in patients with or without significant coronary artery disease (CAD).A total of 2225 patients undergoing coronary angiography (CAG) between January 2011 and November 2014 were recruited in our study. Based on the CAG results, patients were divided into the left dominance (LD) group, right dominance (RD) group, and co-dominance (CD) group. Multinomial logistic regression was applied to analyze the relationships between coronary dominance and triple-vessel CAD.We found that patients with RD had a higher prevalence of triple-vessel CAD (36.6% vs 27.3%, P = .008) and significant stenosis in the right coronary artery (40.5% vs 29.2%, P = .001). In addition, results of multinomial logistic regression analysis showed that RD was significantly associated with the triple-vessel disease (odds ratio 1.768, 95% confidence interval 1.057–2.956, P = .030).In conclusion, RD positively correlated with triple-vessel CAD rather than LD or CD in patients. This result suggested that RD may serve as a risk factor for triple-vessel CAD and more effective measures should be taken in RD patients to prevent fatal cardiovascular events.

show abstract

Worse clinical outcomes following percutaneous coronary intervention with a high SYNTAX score

Cited by 19 publications

References 18 publications

Use of the SYNTAX Score II to predict mortality in interventional cardiology

Use of the SYNTAX Score II to predict mortality in interventional cardiology

Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studies

Impact of right coronary dominance on triple-vessel coronary artery disease

Contact Info

Product

Resources

About