Comparison Between the NERS (New Risk Stratification) Score and the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) Score in Outcome Prediction for Unprotected Left Main Stenting

Chen, Shao‐Liang; Chen, Jack P.; Mintz, Gary S.; Xu, Bo; Kan, Jing; Ye, Fei; Zhang, Junjie; Sun, Xiaobo; Xu, Yawei; Jiang, Qing; Zhang, Aiping; Stone, Gregg W.

doi:10.1016/j.jcin.2010.04.006

Cited by 96 publications

(62 citation statements)

References 22 publications

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“…The aims of our study were: (1) to assess the prognostic value of angiographic characteristics represented by the SYNTAX score versus clinical variables represented by the EuroSCORE for the prediction of major adverse cardiac events (MACE) in patients after ULMCA-PCI in a ''realworld'' setting, (2) to develop a combined risk model for daily practice, and (3) to compare this combined risk model including angiographic and clinical characteristics to the recently published risk scores [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

et al. 2012

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Section: Introductionmentioning

confidence: 99%

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

et al. 2012

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“…Por ú ltimo, en nuestro estudio, la puntuació n SYNTAX no presentó una relació n con la mortalidad total. Este resultado concuerda con lo indicado por un reciente informe que señ alaba que la puntuació n SYNTAX tiene una exactitud baja o moderada en la predicció n de la mortalidad por cualquier causa a los 6 meses en los pacientes con estenosis de TCI no protegido tratados con stents (á rea bajo la curva, 0,71; IC95%, 0,60-0,82) 30 . Ese mismo estudio llegó a la conclusió n de que otra puntuació n basada en pará metros clínicos, como la puntuació n New Risk Stratification Score (NERS), tenía mayor exactitud en la evaluació n de la mortalidad total y los MACE 30 .…”

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Seguimiento a largo plazo tras el tratamiento percutáneo del tronco coronario izquierdo no protegido en pacientes de alto riesgo no aptos para cirugía de revascularización

Gómez‐Hospital

Gomez‐Lara

Rondán

et al. 2012

Revista Española de Cardiología

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“…In contrast, patients with a high SYNTAX score had a higher rate of distal LMCA lesions, the majority of which were associated with two-or three-vessel disease for which CABG may be a better alternative than PCI. Another score, the New Risk Stratification (NERS) score, showed a higher sensitivity and specificity to predict clinical outcome (21). The current ACCF/AHA/SCAI guidelines (5) provide a class IIa recommendation for PCI of left main ostial or midshaft disease when it exists in isolation or in combination with onevessel disease; a class IIb recommendation for left main distal bifurcation disease when it exists in isolation or in combination with one-vessel disease; a class IIb recommendation for any left main disease with concomitant two-or three-vessel disease and a SYNTAX score ≤32; and, finally, a class III recommendation for left main disease with concomitant two-or three-vessel disease and a SYNTAX score ≥33.…”

Section: Risk Stratificationmentioning

confidence: 99%

Percutaneous coronary intervention for the treatment of unprotected left main coronary artery disease

Dubey¹,

Bhattacharya²

2014

Curr Res Cardiol

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T he prevalence of left main coronary artery (LMCA) disease is low. Approximately 4% to 7% of patients with acute myocardial infarction (MI) undergoing coronary angiography (CAG) have significant involvement of the LMCA (1,2). Patients with LMCA disease are at high risk for cardiovascular events because occlusion of this vessel compromises flow to at least 75% of the left ventricle and 100% in cases of the left dominant type. As a result, severe LMCA disease reduces flow to a considerable portion of the myocardium, placing the patient at high risk for life-threatening events such as left ventricular dysfunction and arrhythmias (3,4). Patients with unprotected LMCA disease treated medically have a three-year mortality rate of 50% (3). Although coronary artery bypass graft (CABG) surgery has been considered the 'gold standard' for unprotected LMCA revascularization, percutaneous coronary intervention (PCI) has recently emerged as a possible alternative mode of revascularization in carefully selected patients. The current American College of Cardiology Foundation (ACCF)/American Heart Association (AHA)/Society for Cardiovascular Angiography and Interventions (SCAI) guidelines also state that PCI for LMCA disease is a reasonable alternative to CABG in patients who have anatomical conditions associated with good procedural and longer-term outcomes, and who are at increased risk for surgery (5). Case PresentationA 76-year-old man with a history of systemic hypertension presented to the emergency department of the authors' institution with acute-onset left-sided chest pain and shortness of breath of 1 h duration. The patient was a past smoker. In the emergency department, his blood pressure (BP) was 120/80 mmHg, with a heart rate of 85 beats/min. The initial electrocardiogram showed sinus rhythm at a heart rate of 90 beats/min with ST depression in leads II, III, aVF, V4, V5 and V6. He was diagnosed with acute coronary syndrome (ACS), admitted to the coronary care unit and managed with low-molecular-weight heparin, acetylsalicylic acid, clopidogrel, beta-blockers and atorvastatin.Thirty minutes later, the patient complained of increased intensity in chest pain and difficulty breathing. His systolic BP decreased to 60 mmHg with an undetectable diastolic BP. A dopamine drip at a rate of 15 μg/kg/min was started and the patient was transferred to the catheterization laboratory for CAG. CAG was performed via right femoral artery approach, which revealed approximately 90% stenosis in the mid part of the LMCA ( Figures 1A and 1B), 70% stenosis in the mid segment of the left anterior descending (LAD) artery and 70% to 80% stenosis in the proximal right coronary artery. The left circumflex coronary (LCX) artery was normal.During the procedure, his BP remained low; a drip of noradrenaline was also started. Relatives of the patient were counselled about the disease, its prognosis and the need for emergency CABG. Because CABG surgery was not available at the authors' centre and the patient was in cardiogenic shock, a decision was...

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Comparison Between the NERS (New Risk Stratification) Score and the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) Score in Outcome Prediction for Unprotected Left Main Stenting

Abstract: The NERS score was more predictive of MACE than the SYNTAX score was. Further study is needed to address their relative roles in assessment for appropriateness of coronary artery bypass graft versus percutaneous coronary intervention for unprotected left main coronary artery stenosis.

Cited by 96 publications

References 22 publications

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

Seguimiento a largo plazo tras el tratamiento percutáneo del tronco coronario izquierdo no protegido en pacientes de alto riesgo no aptos para cirugía de revascularización

Percutaneous coronary intervention for the treatment of unprotected left main coronary artery disease

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