Document Detail


The incremental impact of residual SYNTAX score on long-term clinical outcomes in patients with multivessel coronary artery disease treated by percutaneous coronary interventions.
MedLine Citation:
PMID:  25413668     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: to broaden the data supporting the use of the residual SYNTAX score (rSS) to define 'reasonable' ICR in order to improve the allocation of patients with severe CAD to surgical/percutaneous revascularization and long-term clinical outcomes. Introduction: Incomplete coronary revascularization (ICR) is associated with a worse prognosis in patients with severe coronary artery disease (CAD), yet no consensus exists regarding its definition. Methods: We studied 148 consecutive patients with triple vessel/left main (3VD/LM) coronary artery disease treated by percutaneous coronary interventions (PCI). Clinical outcomes at 3 years were collected, the SS and rSS were calculated. We used various definitions of 'reasonable' ICR:no post-PCI total occlusion, single vs. mutivessel residual post-PCI disease and the rSS at a cutoff value determined according to ROC curve fitted for 3 years major adverse cardiovascular and cerebrovascular adverse events(MACCE) in order to determine which definition has the strongest correlation with long-term outcomes. Results: rSS ≤ 8 was associated with significant reductions in 3 year MACCE (19.4 vs. 51.1%, HR=3.62, P=0.014) Death/MI/CVA (13.7 vs. 28.8%, HR=6.01, p=0.030) and repeat revascularization (8.6 vs. 28.9%, HR=3.44, p=0.033) using a Cox proportional hazard ratio model adjusted to baseline characteristics, whereas single vessel residual disease and absence of total occlusion were not. Conclusions: 'reasonable' ICR as determined by rSS carries better long-term prognosis in terms of clinical outcomes vs. more extensive residual coronary disease in patients with 3VD/LM coronary artery disease treated by PCI. The rSS may improve the allocation of coronary patients to the optimal mode of revascularization. This article is protected by copyright. All rights reserved.
Authors:
Guy Witberg; Ifat Lavi; Abid Assali; Hana Vaknin-Assa; Eli Lev; Ran Kornowski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-20
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-21     Completed Date:  -     Revised Date:  2014-11-21    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Wiley Periodicals, Inc., a Wiley company.
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