Clinical SYNTAX score predicts outcomes of patients undergoing coronary artery bypass grafting

Melina, Giovanni; Angeloni, Emiliano; Refice, Simone; Monti, Francesco; Serdoz, Roberto; Rosato, Stefano; Seccareccia, Fulvia; Colivicchi, Furio; Serdoz, Roberta; Paneni, Francesco; Sinatra, Riccardo

doi:10.1016/j.ahj.2017.03.016

Cited by 12 publications

(8 citation statements)

References 30 publications

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“…The SYNTAX score of ≥33 points is widely accepted criteria to select coronary artery bypass grafting (CABG) over PCI in treatment of the left main lesions. SYNTAX score of 22–32 points is defined as moderate complexity of coronary artery disease, both the CABG and PCI can be adopted [8].…”

Section: Introductionmentioning

confidence: 99%

Apolipoprotein A1 is associated with SYNTAX score in patients with a non-ST segment elevation myocardial infarction

Chen

Yang

et al. 2019

Lipids Health Dis

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Background The study was designed to investigate lipid profile and SYNTAX score in patients with non-ST segment elevation myocardial infarction (NSTEMI). Methods 311 patients with NSTEMI were enrolled. The demographic, clinical data, blood samples and SYNTAX score were documented. The Pearson linear correlation was used to detect confounding factors linearly correlated with SYNTAX score. The significantly correlated confounding factors were put into the multiple linear regressions. Results The Pearson linear correlation showed that high-density lipoprotein- cholesterol (HDL-C) and apolipoprotein A1 (ApoA1) were significantly correlated with Syntax Score ( r = − 0.119, P = 0.044 and r = − 0.182, P = 0.002, respectively). The multiple linear regressions for Syntax Score were built using HDL-C and ApoA1, respectively. After the adjustment of other significantly correlated confounding factors such as white blood cell count (WBC), myohemoglobin (MB), glutamic-oxalacetic transaminase (AST) and creatinine, the ApoA1 still showed significant association with Syntax Score ( β = − 0.151, P = 0.028). The area under curve was (AUC) 0.624 and the optimal cutoff value is 1.07 g/L when using ApoA1 to predict moderate and severe coronary artery lesions. The patients with ApoA1 ≥ 1.07 g/L and < 1.07 g/L have the Syntax Scores of 12.21 ± 11.58 and 16.33 ± 11.53, respectively ( P = 0.001). Conclusions The ApoA1 is the only lipid factor significantly associated with complexity of coronary artery lesion in patients with NSTEMI, the patients with ApoA1 < 1.07 g/L may have more complex coronary artery lesions.

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Section: Introductionmentioning

confidence: 99%

Apolipoprotein A1 is associated with SYNTAX score in patients with a non-ST segment elevation myocardial infarction

Chen

Yang

et al. 2019

Lipids Health Dis

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“…Later, in a different study, log CSS was also found to enhance risk stratification for 3‐year mortality after PCI compared with the SS 25 . Melina et al 26 showed log CSS was superior to SS in terms of predicting mortality and major adverse cardiac/cerebrovascular events in patients who underwent elective CABG. To the best of our knowledge, the present study is the first one that evaluates the predictive value and clinical utility of log CSS for in‐hospital mortality in STEMI patients undergoing emergent CABG.…”

Section: Discussionmentioning

confidence: 99%

Utility of logistic clinical SYNTAX score in prediction of in‐hospital mortality in ST‐elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery

et al. 2021

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Aim The logistic clinical SYNTAX score (log CSS) is a combined risk scoring system including clinical and anatomic parameters; it has been found to be effective for the prediction of mortality in patients with ST‐elevation myocardial infarction (STEMI). Coronary artery bypass grafting (CABG) in the primary treatment of acute myocardial infarction is still debated. In the present study, we aimed to evaluate the utility of log CSS to stratify the risk of in‐hospital mortality in acute STEMI patients undergoing emergent CABG for primary revascularization. Method In total, 88 consecutive patients with acute STEMI, who did not qualify for primary percutaneous coronary intervention and required emergent CABG were included in our study. Nine of 88 patients died during hospitalization. The study population was divided into two groups as in‐hospital survivors and non‐survivors. Log CSS and SYNTAX score (SS) were calculated for both groups and two groups were compared in terms of demographics, preoperative, intraoperative, postoperative characteristics, SS and log CSS. Results Log CSS was found to be an independent predictor of in‐hospital mortality, log CSS > 10.5 had 89% sensitivity, 81% specificity (area under the curve: 0.927; 95% confidence interval: 0.855–0.993). Moreover, peak troponin level was an independent predictor of in‐hospital mortality. Glucose level, cardiopulmonary resuscitation before operation, glomerular filtration rate, left ventricular ejection fraction, and Killip class were significantly associated with in‐hospital mortality. Conclusion Log CSS may improve the accuracy of risk assessment in patients who are undergoing emergent CABG for primary revascularization of STEMI.

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“…Приведенный анализ изучил влияние одной из шкал оценки тяжести поражения коронарного русла на внутрибольничную летальность в условиях реальной клинической практики и своевременно проведенной реперфузионной терапии. Индекс SYNTAX Score был выбран как валидизированный критерий оценки, поскольку хорошо изучен в литературе применительно к чрескожному коронарному вмешательству и коронарному шунтированию при ИМпST [7,22]. Практической значимостью нашего анализа может стать необходимость переоценки значимости индекса SYNTAX Score и проводимого лечения в группе больных с высоким баллом по SYNTAX Score [20][21][22].…”

Section: Discussionunclassified

Role of Syntax Score Scale in the Stratification of the Nosocomial Risk of Cardiovascular Complications and Lethality in Patients With St-Segment Elevation Myocardial Infarction

Nemik

Matyushin

Ustyugov

2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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The lethality of patients with acute myocardial infarction with ST-segment elevation (STEMI) depends on many factors. In conditions of timely transportation of the patient to the center of percutaneous coronary intervention one of these factors is the severity of the coronary bed lesion. In clinical practice, the most common method of assessing such lesions is the SYNTAX Score scale.Aim. To study the impact of the assessment by angiographic SYNTAX Score scale on in-hospital complications and lethality in patients with STEMI.Material and methods. The single-center observational retrospective study was performed. The medical data of 816 cases of treatment of patients with STEMI in the first 6 hours from the onset of symptoms were analyzed. All patients underwent reperfusion therapy (primary percutaneous coronary intervention or pharmacoinvasive strategy (FIS)) with assessment of the SYNTAX Score index prior to intervention. The main group (SYNTAX Score ≤22 points) and the comparison group (SYNTAX Score index >22 points) were comparable in terms of clinical characteristics and time delays.Results. An increase in the SYNTAX Score more than 22 points was an independent predictor of hospital complications and lethality (4.9% for SYNTAX Score ≤22 points and 21.9% – for >22 points). The group with a high SYNTAX index was older, had a higher proportion of smokers (46.8% vs 36.1%, p=0.015) and patients with myocardial infarction history (38.5% vs 20.6%, p<0.001), fewer patients to whom the FIS was applied (33.3% vs 45.7%; p=0.017). Nevertheless, in multivariate analysis, the initial clinical data of patients influenced the hospital prognosis, first of all in patients with SYNTAX Score ≤22 points. The group with a more severe lesion of the coronary bed was represented by patients with frequent development of pulmonary edema, cardiogenic shock and ventricular fibrillation. Cardiac complications in this group of patients were less dependent on the initial characteristics. Strong SYNTAX Score correlations were found with left ventricular ejection fraction (r=-0.156, p<0.001), the number of implanted stents (r=0.226, p<0.001), and with complications and lethality. The frequency of hemorrhagic complications did not depend on the severity of the coronary bed lesion.Conclusion. The use of the SYNTAX Score scale in clinical practice is scientifically grounded and advisable. Stratification of high-risk patients with STEMI during primary angiography based on the SYNTAX Score scale has a high prognostic value.

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Clinical SYNTAX score predicts outcomes of patients undergoing coronary artery bypass grafting

Cited by 12 publications

References 30 publications

Apolipoprotein A1 is associated with SYNTAX score in patients with a non-ST segment elevation myocardial infarction

Apolipoprotein A1 is associated with SYNTAX score in patients with a non-ST segment elevation myocardial infarction

Utility of logistic clinical SYNTAX score in prediction of in‐hospital mortality in ST‐elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery

Role of Syntax Score Scale in the Stratification of the Nosocomial Risk of Cardiovascular Complications and Lethality in Patients With St-Segment Elevation Myocardial Infarction

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