A New Tool for the Risk Stratification of Patients With Complex Coronary Artery Disease: The Clinical SYNTAX Score.
Summary of "A New Tool for the Risk Stratification of Patients With Complex Coronary Artery Disease: The Clinical SYNTAX Score."
Background-Presently, no effective risk model exists to predict long-term mortality or other major adverse cardiovascular and cerebrovascular events (MACCE) in those patients undergoing percutaneous coronary intervention (PCI). This study aimed to assess whether the Clinical SYNTAX Score (CSS) calculated by multiplying the SYNTAX Score to a modified ACEF score (age/ejection fraction +1 for each 10 mL the creatinine clearance <60 mL/min per 1.73 m(2)) would improve the ability of either score to predict mortality and MACCE. METHODS AND
RESULTS:
27.5 (n=171). At 1-year follow-up, rates of repeat revascularization and MACCE were significantly higher in the highest tertile group. At 5-year follow-up, CSS(HIGH) had a comparable rate of myocardial infarction, a trend toward a significantly higher rate of death, and significantly higher rates of repeat revascularization and overall MACCE compared with patients in the lower 2 tertiles. The respective C-statistics for the CSS, SYNTAX Score, and ACEF score for 5-year mortality were 0.69, 0.62, and 0.65 and for 5-year MACCE were 0.62, 0.59, and 0.57. Conclusions-An improvement in the ability of the SYNTAX Score to predict MACCE and mortality can be achieved by combining the SYNTAX Score with a simple clinical risk score incorporating age, ejection fraction, and creatinine clearance to produce the Clinical SYNTAX score. Clinical Trial Registration-
URL:
http://www.clinicaltrials.gov. Unique identifier: NCT00235170.
Affiliation
Department of Interventional Cardiology, Erasmus MC, Rotterdam, The Netherlands; Cardialysis, Rotterdam, The Netherlands; and Boston Scientific Corporation, Natick, Mass.
Journal Details
This article was published in the following journal.
Name: Circulation. Cardiovascular interventions
ISSN: 1941-7632
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20647561
- DOI: http://dx.doi.org/10.1161/CIRCINTERVENTIONS.109.914051
Medical and Biotech [MESH] Definitions
Internal Mammary-coronary Artery Anastomosis
Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, circumflex artery, or anterior descending coronary artery. The internal mammary artery is the most frequent choice, especially for a single graft, for coronary artery bypass surgery.
Coronary Artery Bypass
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
Coronary-subclavian Steal Syndrome
A complication of INTERNAL MAMMARY-CORONARY ARTERY ANASTOMOSIS whereby an occlusion or stenosis of the proximal SUBCLAVIAN ARTERY causes a reversal of the blood flow away from the CORONARY CIRCULATION, through the grafted INTERNAL MAMMARY ARTERY (internal thoracic artery), and back to the distal subclavian distribution.
Gastroepiploic Artery
Abdominal artery that follows the curvature of the stomach. The right gastroepiploic artery is frequently used in CORONARY ARTERY BYPASS GRAFTING; MYOCARDIAL REVASCULARIZATION, and other vascular reconstruction.
Coronary Artery Bypass, Off-pump
Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).
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