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High SYNTAX score predicts worse in-hospital clinical outcomes in patients undergoing primary angioplasty for acute myocardial infarction.
MedLine Citation:
PMID:  23011414     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: A high SYNTAX score (SXscore) is a predictor of adverse outcomes for stable and unstable coronary syndromes. We aimed to examine whether a high SXscore will determine in-hospital clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. METHODS: A total of 646 (mean age 56.1±12.5; 516 males, 130 females) patients with STEMI undergoing a primary percutaneous coronary intervention were evaluated prospectively. The study population was divided into tertiles based on the SXscore values. A high SXscore (n=196) was defined as a value in the third tertile (>21.75), and a low SXscore (n=450) was defined as a value in the lower two tertiles (≤21.75). Patients were followed up for in-hospital clinical outcomes. RESULTS: In-hospital cardiovascular mortality occurred more in the high SXscore group than in the low SXscore group (10.7 and 2.4%, respectively, P<0.001). In a receiver-operating characteristic curve analysis, an SXscore value of 21.75 was identified as an effective cut point in STEMI for in-hospital cardiovascular mortality (area under curve=0.75, 95% confidence interval: 0.66-0.83, P<0.001). An SXscore value of more than 21.75 yielded a sensitivity of 66% and a specificity of 71.5%. A significant association was noted between a high SXscore level and the adjusted risk of in-hospital cardiovascular mortality (odds ratio: 3.92, 95% confidence interval: 1.1-13.9, P=0.03). CONCLUSION: Our findings showed that patients with a high SXscore undergoing primary angioplasty for STEMI have a poor in-hospital survival, and that a high SXscore represents an independent risk factor for in-hospital cardiovascular mortality.
Authors:
Seref Kul; Ozgur Akgul; Huseyin Uyarel; Mehmet Ergelen; Okkes T Kucukdagl; Abdurrahman Tasal; Ercan Erdogan; Ahmet Bacaksz; Osman Sonmez; Mehmet Gul; Nevzat Uslu; Omer Goktekin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-22
Journal Detail:
Title:  Coronary artery disease     Volume:  -     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of aCardiology and bEmergency, Faculty of Medicine, Bezmialem Vakif University cDepartment of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
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