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    
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.
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    
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Angioplasty, Balloon, Coronary
Confidence Intervals
Coronary Artery Bypass*
Coronary Artery Disease / mortality,  surgery*,  therapy
Coronary Vessels / pathology,  surgery
Health Status Indicators*
Kaplan-Meier Estimate
Logistic Models
Multivariate Analysis
Odds Ratio
Proportional Hazards Models
Retrospective Studies
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left

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

Previous Document:  Off-pump coronary bypass surgery is safe in patients with a low ejection fraction (< or =25%).
Next Document:  Efficiency of preoperative tranexamic Acid in coronary bypass surgery: an analysis correlated with p...