Document Detail


Validation of SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) score for prediction of outcomes after unprotected left main coronary revascularization.
MedLine Citation:
PMID:  20630454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study aimed to validate the SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) score representing angiographic complexity after unprotected left main coronary artery (ULMCA) revascularization.
BACKGROUND: The validity of the SYNTAX score has been adequately evaluated.
METHODS: The SYNTAX scores were calculated for 1,580 patients in a large multicenter registry who underwent percutaneous coronary intervention (PCI) (n = 819) or coronary artery bypass graft (CABG) (n = 761) for ULMCA stenosis. The outcomes of interests were 3-year incidences of major adverse vascular events (MAVE), including death, Q-wave myocardial infarction, and stroke and major adverse cardiac and cerebrovascular events (MACCE), including MAVE and target vessel revascularization of ULMCA.
RESULTS: The incidence of 3-year MAVE was 6.2% in the lowest (< or =23), 7.1% in the intermediate (23 to approximately 36), and 17.4% in the highest (>36) SYNTAX score tertile groups after PCI (p = 0.010). However, the incidences of MAVE in the CABG group and MACCE in the PCI and CABG groups did not differ among the SYNTAX tertiles. In subgroups, the MAVE (p = 0.005) and MACCE (p = 0.007) rates according to the SYNTAX score tertiles were significantly different in patients receiving drug-eluting stent, not in those receiving bare-metal stent. When compared with the clinical EuroSCORE (European System for Cardiac Operative Risk Evaluation), the C-indexes of SYNTAX score and EuroSCORE were 0.59 and 0.67, respectively, for discrimination of MAVE and 0.53 and 0.57, respectively, for MACCE.
CONCLUSIONS: The angiographic SYNTAX score seems to play a partial role in predicting long-term adverse events after PCI for ULMCA stenosis. A complementary consideration of patient's clinical risk might improve the predictive ability of risk score.
Authors:
Young-Hak Kim; Duk-Woo Park; Won-Jang Kim; Jong-Young Lee; Sung-Cheol Yun; Soo-Jin Kang; Seung-Whan Lee; Cheol Whan Lee; Seong-Wook Park; Seung-Jung Park
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Validation Studies    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2010-11-02     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  612-23     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Cerebrovascular Disorders / etiology
Coronary Angiography
Coronary Artery Bypass* / adverse effects,  mortality
Coronary Stenosis / mortality,  radiography,  surgery,  therapy*
Drug-Eluting Stents*
Female
Health Status Indicators*
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction / etiology
Paclitaxel / administration & dosage*
Predictive Value of Tests
Proportional Hazards Models
Prosthesis Design
Registries
Reproducibility of Results
Republic of Korea
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 33069-62-4/Paclitaxel
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2010 Jun;3(6):642-7   [PMID:  20630457 ]

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


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