Document Detail


Is the SYNTAX score a predictor of long-term outcome after coronary artery bypass surgery?
MedLine Citation:
PMID:  20534412     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The SYNTAX score was introduced to measure the complexity of coronary artery disease. Although a high SYNTAX score is indicative of a worse long-term outcome after percutaneous coronary intervention (PCI), it remains unclear whether it is also true for coronary artery bypass grafting (CABG).
METHODS: We analyzed 200 consecutive CABG patients who underwent operations in 2002. Demographic and intraoperative data, perioperative outcomes, and 5-year outcomes were obtained. The SYNTAX score was calculated retrospectively by reviewing the original diagnostic angiograms. After excluding patients who had undergone CABG or PCI treatment within 6 months before surgery, we included 154 patients in the study. Patients were partitioned into tertiles according to the SYNTAX score (low, < or =18; intermediate, >18-26; high, >26). Cox regression analysis was used to identify baseline and procedural predictors for the combined end point of 5-year major adverse cardiac and cerebrovascular events (MACCE) and its components. Cumulative event rates were estimated by Kaplan-Meier methods.
RESULTS: The mean (+/-SD) age was 66.6 +/- 8.5 years, the mean ejection fraction was 56.4% +/- 13.6%, and the mean logistic EuroSCORE was 4.2% +/- 4.7%. The SYNTAX score ranged between 2 and 52. The overall survival rate was 94.8% at 1 year and 84.1% at 5 years. The rate of freedom from MACCE was 92.9% and 78.0% at 1 and 5 years, respectively. Only a higher EuroSCORE, a New York Heart Association class of III to IV, and smoking could be identified with Cox regression as risk factors for MACCE during follow-up. The overall survival and MACCE rates of the 3 SYNTAX score subgroups were not significantly different.
CONCLUSIONS: Complex coronary pathology as measured by the SYNTAX score did not affect the long-term outcome after CABG in this study.
Authors:
David M Holzhey; Martin M Luduena; Ardawan Rastan; Stephan Jacobs; Thomas Walther; Friedrich W Mohr; Volkmar Falk
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  13     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2011-06-02     Revised Date:  2011-08-05    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E143-8     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany. dholzhey@web.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary
Confidence Intervals
Coronary Artery Bypass*
Coronary Artery Disease / mortality,  surgery*,  therapy
Coronary Vessels / pathology,  surgery
Female
Germany
Health Status Indicators*
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Prognosis
Proportional Hazards Models
Retrospective Studies
Stroke Volume
Switzerland
Time Factors
Treatment Outcome
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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