EuroSCORE refines the predictive ability of SYNTAX score in patients undergoing left main percutaneous coronary intervention

Influence of Diabetes Mellitus on Long-Term Outcomes of Patients With Unprotected Left Main Coronary Artery Disease Treated With Either Drug-Eluting Stents or Coronary Artery Bypass Grafting

“…[3][4][5] Therefore, much attention has been paid to identifying appropriate risk stratification to help determine the optimal revascularization strategy in patients with ULMCA disease. [6][7][8] Among many risk factors, diabetes was a strong independent predictor of adverse outcome in patients with coronary artery disease. [9][10][11] Previous studies have shown CABG performed better than PCI in diabetic patients with multivessel disease, [12][13][14] indicating that diabetes might be an important consideration when selecting a revascularization strategy in patients with severe coronary artery disease.…”

Beyond the SYNTAX Score

“…In a series of 255 patients undergoing ULMCA PCI, there was a weak, yet significant, linear relationship between the EuroSCORE and the SYNTAX score (R 2 =0.201, P=0.001), indicating that the 2 models, although with some areas of overlap, also include different and possibly complementary information. 55 This notion corroborates the rationale for clinical and angiographic scores to be merged into a single classification system ( Table 3). The Global Risk Classification (GRC) is a combined scheme encompassing different strata of the EuroSCORE and SYNTAX score.…”

“…The Global Risk Classification (GRC) is a combined scheme encompassing different strata of the EuroSCORE and SYNTAX score. 55 The GRC was found to refine the prognostic ability of the EuroSCORE and the SYNTAX score taken in isolation and led to NRI of ~25% of patients undergoing ULMCA PCI into more coherent risk categories. 55,56, 59 In a recent validation study, Serruys et al 60 investigated the ability of the GRC to improve the identification of low-risk patients with ULMCA or 3-vessel disease who would achieve comparable 3-year outcomes between PCI and CABG.…”

A Tale of Two Techniques: Demystifying the Myth

“…The anatomical SYNTAX score, with low (<23), intermediate (23)(24)(25)(26)(27)(28)(29)(30)(31)(32) or high (>32) categories, 8,12 became a sentinel tool in the SYNTAX trial and pioneered the now-popular "Heart Team" approach, in which a cardiac surgeon and interventional cardiologist determine the optimal revascularization modality for patients with 3VD/ULMCA disease. It combines the importance of diseased vessel segment weighting (Leaman score), adverse lesion characteristics (American College of Cardiology/American Heart Association lesion classification, and total occlusion characteristics from the European TOTAL Surveillance Study) and the Medina classification system for bifurcation lesions.…”

“…age/ejection fraction + 1 point for every 10 ml/ min reduction in creatinine clearance below 60 ml/ min/1.73 m 2 (up to a maximum of 6 points)]), the Global Risk score (a combination of the SYNTAX score and EuroSCORE) and the EuroHeart score. [18][19][20][21][22][23][24][25][26][27] The latest addition to this risk stratification mélange is the SYNTAX score II, which includes a nomogram for bedside application to obtain long-term mortality predictions for individual patients considering CABG or PCI. 28 This score, which was externally validated in the multinational DELTA (n=2,891) and Credo-KYOTO (n=3,896) registries, 8,29 consists of two anatomical (SYNTAX score and ULMCA disease) and six clinical (age, creatinine clearance, left ventricular ejection fraction, sex, chronic obstructive pulmonary disease and peripheral vascular disease) variables.…”