Predictive Value of Gensini Score in the Long-Term Outcomes of Patients With Coronary Artery Disease Who Underwent PCI

Wang, Kai-Yang; Zheng, Ying‐Ying; Wang, Tingting; Ma, Yun; Xie, Xiang

doi:10.3389/fcvm.2021.778615

Cited by 37 publications

(34 citation statements)

References 18 publications

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“…Charach et al conducted a study in which they concluded that the Gensini score could be a useful scoring system in angiographically detecting the severity of coronary artery disease, showing prognosis, and predicting possible benefits from treatments [ 8 ]. Wang et al indicated in their study that the Gensini score was an independent predictor of long-term adverse outcomes in patients with CAD who underwent PCI, and it had more predictive value in the population with diabetes [ 9 ]. The lack of follow-up data in our study is the main limitation of our study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of SYNTAX and Gensini Scores in the Decision of Surgery or Percutaneous Revascularization in Patients With Multivessel Coronary Artery Disease

Boyraz¹,

Peker²

2022

Cureus

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Introduction: Many scoring systems have been developed to determine the extent of coronary artery disease (CAD) in patients with multi-vessel disease. The most widely used of these are Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and Gensini scoring. Gensini scoring system can successfully show coronary plaque burden. In our study, we aimed to test the predictive power of SYNTAX and Gensini scores for surgical or percutaneous intervention decisions made by the cardiac team in patients with three-vessel disease.Methods: A total of 476 patients without ST-elevation myocardial infarction with the three-vessel disease were included in the study. SYNTAX and Gensini scores of the patients were calculated from their coronary angiographies. Receiver operating characteristic curve (ROC-curve) analysis was performed using both scores.Results: Both the SYNTAX score and Gensini score were able to predict heart team decisions (AUC: 0.759, 0.680; p<0.001). Diabetes and smoking were more common in patients who were decided to have surgery (p<0.001). Conclusion:In the light of our study results, the decisions to be made with the SYNTAX score will be closer to the decisions of the heart team than the Gensini score.

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Section: Discussionmentioning

confidence: 99%

Comparison of SYNTAX and Gensini Scores in the Decision of Surgery or Percutaneous Revascularization in Patients With Multivessel Coronary Artery Disease

Boyraz¹,

Peker²

2022

Cureus

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“…The logistic regression in this study revealed that the factors positively associated with AMI in the CAE population were higher inflammatory status and poor lipid profiles. As known, CAE is an inflammatory disease ( 6 , 23 ); therefore, a higher inflammatory status might be predispose patients to occurrence of thrombotic events. Other underlying factors relating to AMI in patients with CAE should be explore further.…”

Section: Discussionmentioning

confidence: 99%

“…Third, the detailed treatment strategy for patients with CAE was explored in this study. From the perspective of MACE prevention, the progression of atherosclerotic lesions should be prevented in patients with CAE ( 23 , 24 ) while the anti-thrombotic treatments, are indicated for patients with CAE + AMI ( 25 , 26 ). As reported in our previous study, patients with CAE and CHD had minimal ectasia progression but the atherosclerosis progressed gradually ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…As reported in our previous study, patients with CAE and CHD had minimal ectasia progression but the atherosclerosis progressed gradually ( 3 ). The dynamic change of CAE might be mainly manifested by the development of atherosclerotic changes but not the extent of ectasia; therefore, for patients with CAE, the main treatment might be to prevent the progression of atherosclerotic lesions; for CAE + AMI patients, the thrombotic events might be related to ectasia itself (higher inflammatory status and poor lipid profiles) or other unknown factors ( 23 ), and the remodeling of left ventricular could be improved by ACEI/ARBs. Most medicines for CAE are based on the current treatment options for CHD, such as antithrombotic therapy, statins, and trimetazidine ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

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Five-years’ prognostic analysis for coronary artery ectasia patients with coronary atherosclerosis: A retrospective cohort study

Liu

Gao

Liang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundMost of coronary artery ectasia (CAE) patients have comorbid coronary atherosclerosis. It was lack of prognostic data for CAE patients with coronary heart disease (CHD) and for whom with acute myocardial infarction (AMI).ObjectiveTo determine the overall prognosis for CAE patients.Materials and methodsThis study was a retrospective cohort study. Fifty-one patients with CAE and comorbid AMI (CAE + AMI) and 108 patients with CAE and comorbid CHD (CAE + CHD) were enrolled and matched to non-CAE subjects at a ratio of 1:3 using a propensity score method, respectively. Controls for CAE + AMI group were 153 AMI patients, controls for CAE group were 324 CHD patients and 329 participants with relatively normal coronary arteries (CON). We followed them up to observe major cardiovascular events (MACE).ResultsThe Kaplan-Meier curves showed that the prognosis in CAE + AMI group was worse than in AMI group (5-year non-MACE rate: 62.70% vs. 79.70%, P = 0.010), the prognosis in CAE group was worse than in CHD and CON groups (5-year non-MACE rate: 74.10% vs. 85.80% and 96.70%, respectively, P = 0.000). The main MACEs in CAE + AMI and CAE groups were AMI reoccurrence (19.61% vs. 4.57%, P = 0.002) and re-hospitalization due to repeated angina pectoris (14.81% vs. 8.33% and 2.74%, P = 0.000), respectively. Additionally, the COX regression analysis revealed that the protective factors for preventing MACE in CAE + AMI group included antiplatelet agents (hazard ratio = 0.234, P = 0.016) and angiotensin-converting enzyme inhibitor/angiotensin receptor inhibitor (ACEI/ARB, hazard ratio = 0.317, P = 0.037). Whereas the main factor promoting MACE in CAE group was the degree of coronary stenosis (Gensini score, hazard ratio = 1.011, P = 0.022).ConclusionThe prognosis of patients with CAE + AMI was worse than that of those with AMI. The overall prognosis of patients with CAE was worse than that of those with CHD. CAE + AMI and CAE groups had different characteristics; the former was prone to AMI reoccurrence, and the latter was prone to repeated angina pectoris. To prevent MACE, medications, including antiplatelets and ACEI/ARBs, are indicated for patients with CAE + AMI, whereas prevention of the progression of atherosclerotic lesions is indicated for patients with CAE.

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“…CHD was defined as ≥50% lumen stenosis of the main coronary artery branches. The severity of coronary stenosis was determined by the Gensini score 14 . First, coronary stenosis was quantitatively assessed.…”

Section: Methodsmentioning

confidence: 99%

Correlation between plasma sphingosine-1-phosphate and the occurrence and severity of coronary heart disease in postmenopausal women

Deng

Ao²,

Liu

et al. 2022

Menopause

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ObjectiveSphingosine-1-phosphate (S1P) is a bioactive sphingosine with antiatherosclerotic effects. The incidence of coronary heart disease (CHD) increases significantly among women after menopause. We explored the relationship between plasma S1P levels and the occurrence and severity of CHD in postmenopausal women.MethodsPostmenopausal women admitted to our hospital for coronary angiography because of chest pain–like symptoms were included in our study. By 1:1 age matching (age difference ≤5 y), 166 women in the CHD group and control group were enrolled. The plasma S1P concentration was determined, and the Gensini score was calculated to decide the severity of CHD.ResultsPlasma S1P levels were significantly lower in the CHD group of postmenopausal women (P < 0.001). S1P (odds ratio, 0.952; 95% CI, 0.934-0.970) was an independent predictor of the occurrence of CHD in postmenopausal women. The area under the curve for S1P to predict the occurrence of CHD was 0.653 (95% CI, 0.595-0.712), and the cutoff value was 96.89 ng/mL. The plasma S1P level was the lowest in the high-tertile group of the Gensini score (P < 0.001), and the plasma S1P (odds ratio, 0.948; 95% CI, 0.926-0.970) was an independent predictor of a high Gensini score in postmenopausal women with CHD.ConclusionsPlasma S1P is an independent risk factor of the occurrence and severity of CHD in postmenopausal women. The occurrence and aggravation of CHD in postmenopausal women may be related to levels of S1P.

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Predictive Value of Gensini Score in the Long-Term Outcomes of Patients With Coronary Artery Disease Who Underwent PCI

Cited by 37 publications

References 18 publications

Comparison of SYNTAX and Gensini Scores in the Decision of Surgery or Percutaneous Revascularization in Patients With Multivessel Coronary Artery Disease

Comparison of SYNTAX and Gensini Scores in the Decision of Surgery or Percutaneous Revascularization in Patients With Multivessel Coronary Artery Disease

Five-years’ prognostic analysis for coronary artery ectasia patients with coronary atherosclerosis: A retrospective cohort study

Correlation between plasma sphingosine-1-phosphate and the occurrence and severity of coronary heart disease in postmenopausal women

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