Baseline and residual SYNTAX score in predicting outcomes after acute infarct angioplasty

Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic impact of baseline and residual SYNTAX scores in cardiogenic shock

Javanainen

Sans‐Roselló

Harjola

et al. 2018

“…Farooq validated the prognostic impact of the rSS on adverse outcomes in the SYNTAX trial, which showed that the rSS is a powerful indicator of 5‐year mortality . The prognostic value of the rSS has also been confirmed for patients with multivessel CAD, unprotected left main disease, MI while undergoing primary PCI, complex disease treated with second‐generation drug‐eluting stents, and all PCI patients . However, no studies or subgroup analyses have been performed to determine whether the rSS is meaningful for patients with CRI.…”

Section: Discussionmentioning

confidence: 99%

Impact of the residual SYNTAX score on clinical outcomes after percutaneous coronary intervention for patients with chronic renal insufficiency

Yan

Wang

et al. 2019

Objectives This study demonstrated the prognostic value of the residual SYNTAX score (rSS) for patients with chronic renal insufficiency (CRI). Background The rSS has been proposed as a useful tool for quantifying and stratifying the degree and complexity of residual stenosis and predicting long‐term clinical outcomes following percutaneous coronary intervention (PCI). However, it has never been validated for patients with CRI. Methods A total of 2,468 consecutive patients with an estimated glomerular filtration rate <90 ml/min/1.73 m2 who underwent PCI were retrospectively enrolled. Patients with rSS >0 were defined as having incomplete revascularization and were stratified into the reasonable incomplete revascularization (RICR; 0 < rSS ≤ 8) group or the incomplete revascularization (ICR; rSS >8) group. Their outcomes were compared to those of the complete revascularization (CR) group. Results During follow‐up (median, 3 years; range, 1.5–5 years), the ICR group had the highest incidence of all‐cause death, cardiac death, myocardial infarction (MI), unplanned revascularization, stroke, and major adverse cardiovascular and cerebrovascular events (MACCE). Despite having higher rates of unplanned revascularization and MACCE, RICR group had comparable all‐cause mortality, cardiac mortality, MI, and stroke with CR group. A multivariable Cox analysis indicated that rSS was an independent predictor of cardiac death, MI, unplanned revascularization, stroke, and MACCE. Furthermore, compared with baseline SYNTAX score, rSS had stronger prognostic accuracy when predicting the risk of unplanned revascularization, stroke, and MACCE at the 3‐year follow‐up. Conclusions The rSS is a powerful indicator of clinical outcomes and may help determine reasonable levels of revascularization for patients with CRI following PCI.

Patients with COVID‐19 who experience a myocardial infarction have complex coronary morphology and high in‐hospital mortality: Primary results of a nationwide angiographic study

Abizaid

Campos

Guimarães

et al. 2021

Objectives We aimed to explore angiographic patterns and in‐hospital outcomes of patients with concomitant coronavirus disease‐19 (COVID‐19) and myocardial infarction (MI). Background Patients with COVID‐19 may experience MI during the course of the viral infection. However, this association is currently poorly understood. Methods This is a multicenter prospective study of consecutive patients with concomitant COVID‐19 and MI who underwent coronary angiography. Quantitative and qualitative coronary angiography were analyzed by two observers in an independent core lab. Results A total of 152 patients were included, of whom 142 (93.4%) had COVID‐19 diagnosis confirmation. The median time between symptom onset and hospital admission was 5 (1–10) days. A total of 83 (54.6%) patients presented with ST‐elevation MI. The median angiographic Syntax score was 16 (9.0–25.3) and 69.0% had multi‐vessel disease. At least one complex lesion was found in 73.0% of patients, 51.3% had a thrombus containing lesion, and 57.9% had myocardial blush grades 0/1. The overall in‐hospital mortality was 23.7%. ST‐segment elevation MI presentation and baseline myocardial blush grades 0 or 1 were independently associated with a higher risk of death (HR 2.75, 95%CI 1.30–5.80 and HR 3.73, 95%CI 1.61–8.61, respectively). Conclusions Patients who have a MI in the context of ongoing COVID‐19 mostly present complex coronary morphologies, implying a background of prior atherosclerotic disease superimposed on a thrombotic milieu. The in‐hospital prognosis is poor with a markedly high mortality, prompting further investigation to better clarify this newly described condition.