Prediction of 1-Year Clinical Outcomes Using the SYNTAX Score in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Garg, Scot; Sarno, Giovanna; Serruys, Patrick W.; Rodriguez, Alfredo Chapin; Bolognese, Leonardo; Anselmi, Maurizio; Cesare, Nicoletta De; Colangelo, Salvatore; Moreno, Raúl; Gambetti, Stefania; Monti, Monia; Bristot, Laura; Bressers, Marco; García‐García, Héctor M.; Parrinello, Parrinello; Campo, Gianluca; Valgimigli, Marco

doi:10.1016/j.jcin.2010.09.017

Cited by 133 publications

(45 citation statements)

References 36 publications

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“…Higher SS was correlated with poor outcome, major adverse cardiovascular and cerebrovascular events in several studies [11,17]. Previous studies have shown prognostic utility of SS in patients undergoing percutaneous coronary interventions [12,18]. …”

Section: Discussionmentioning

confidence: 96%

Relation of Epicardial Fat Thickness and Cardio-Ankle Vascular Index to Complexity of Coronary Artery Disease in Nondiabetic Patients

et al. 2013

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Objectives: Arterial stiffness and epicardial fat thickness (EFT) are associated with coronary artery disease (CAD). The cardio-ankle vascular index (CAVI) is a novel marker of arterial stiffness. The SYNTAX score (SS) reflects the complexity of CAD. We aimed to evaluate the relation of EFT and CAVI with CAD complexity in nondiabetic patients. Method: We enrolled 121 patients undergoing coronary angiography. In all patients, CAVI and EFT were determined. SS were calculated. The relationship between EFT, CAVI and SS was analyzed. Results: CAVI and EFT were significantly correlated with SS (r = 0.537, p < 0.001, and r = 0.629, p < 0.001, respectively) and found to be independent predictors of intermediate-high SS. For the prediction of intermediate-high SS, receiver-operating characteristic curve analysis revealed a cutoff value of 5 mm for EFT (area under the curve, AUC = 0.851, 95% confidence interval, CI, 0.775–0.910) with a specificity of 92.2% and a sensitivity of 77.4% and 8.6 for CAVI (AUC = 0.877, 95% CI 0.805–0.929) with a specificity of 68.9% and a sensitivity of 93.5%. Conclusion: CAD complexity is associated with adverse cardiovascular events. It can be predicted noninvasively with EFT and CAVI in nondiabetic patients with suspected CAD. Thus, patients at high risk for cardiovascular events may be detected early and managed with appropriate treatment strategies.

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Section: Discussionmentioning

confidence: 96%

Relation of Epicardial Fat Thickness and Cardio-Ankle Vascular Index to Complexity of Coronary Artery Disease in Nondiabetic Patients

et al. 2013

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“…Severity of CAD is one of the best predictors of adverse outcome and mortality in STEMI patients [11]. In this study, the burden of atherosclerosis was evaluated by SxS.…”

Section: Discussionmentioning

confidence: 99%

“…The SxS is an anatomic scoring system and indicates the characteristics of a lesion including complexity, morphology, and location in the coronary tree. In recent studies it has been reported that high SxS is associated with clinical outcomes including mortality, mortality/reinfarction, major adverse cardiac events, any stent thrombosis at one-year follow-up and long term cardiac mortality (42 months follow-up) in patients with STEMI undergoing primary PCI [11,12]. The SxS also helps to stratify patients with multivessel and/or left main CAD to either CABG or PCI and reflects the technical difficulty of PCI [11].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction

et al. 2016

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A b s t r a c tBackground: CHADS 2 and CHA 2 DS 2 -VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA 2 DS 2 -VASc-HSF score promote atherosclerosis and are associated with severity of CAD. Aim:To investigate the association of the CHA 2 DS 2 -VASc-HSF score with the severity of CAD as assessed by SYNTAX score (SxS) in patients with ST segment elevation myocardial infarction (STEMI).Methods: A total of 454 consecutive patients with STEMI (males 79%, mean age 57.3 ± 12.9 years), who underwent primary percutaneous coronary intervention were included in our study. The patients were divided into three groups according to the SxS tertiles: low SxS group (SxS < 14; 151 patients), intermediate SxS group (SxS 14-20; 152 patients), and high SxS group (SxS ≥ 21; 151 patients). Results:The CHADS 2 , CHA 2 DS 2 -VASc, and CHA 2 DS 2 VASc-HSF scores were found to be significantly different among the SxS groups (p < 0.001, p < 0.001, and p < 0.001). After multivariate analysis, the CHA 2 DS 2 -VASc-HSF score was associated with high SxS (odds ratio [OR] 1.258, 95% confidence interval [CI] 1.026-1.544; p = 0.028) together with age (OR 1.032, 95% CI 1.013-1.050; p = 0.001) and ejection fraction (OR 0.927, 95% CI 0.901-0.955; p < 0.001). Conclusions:A newly diagnosed CHA 2 DS 2 -VASc-HSF score predicts the severity of atherosclerosis in patients with STEMI.

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“…However, the small number of the reported events and the fact that this analysis did not take into account the angiographic variables associated with clinical outcomes (i.e. the Syntax score, or the residual Syntax score) did not allow us to draw safe conclusions about the additive prognostic value of CTCA in this population [149][150][151][152].…”

Section: Expert Commentarymentioning

confidence: 95%

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Patel

Tarkin

Serruys

et al. 2017

Expert Review of Cardiovascular Therapy

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Introduction: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients. ARTICLE HISTORY

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Prediction of 1-Year Clinical Outcomes Using the SYNTAX Score in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Cited by 133 publications

References 36 publications

Relation of Epicardial Fat Thickness and Cardio-Ankle Vascular Index to Complexity of Coronary Artery Disease in Nondiabetic Patients

Relation of Epicardial Fat Thickness and Cardio-Ankle Vascular Index to Complexity of Coronary Artery Disease in Nondiabetic Patients

Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

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