Prognostic impact of the SYNTAX score II in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: analysis of a four-year all-comers registry

Abstract

Aims: This study aimed to investigate the prognostic impact of the SYNTAX score II (SS-II) on ST-segment elevation myocardial infarction (STEMI) patients undergoing a primary percutaneous coronary intervention (pPCI). Methods and results: This retrospective cohort study included 1,689 patients with STEMI who underwent pPCI between January 2008 and December 2016. The patients were categorised into three groups based on SS-II tertiles (SS-II low tertile <24 [n=585], SS-II intermediate tertile ≥24 and ≤34 [n=567], and SS-II high tertile >34 [n=537]). In-hospital mortality was significantly lower in patients with low and mid SS-II when compared with high SS-II (0.7% vs 0.5% vs 16.4%, p=0.001). During follow-up (median 2.35 years), a high SS-II was positively correlated with MACE (12.3% for low SS-II vs 18.3% for mid SS-II vs 43.2% for high SS-II, p=0.001), all-cause mortality (1.5% vs 3.9% vs 14.2%, p=0.001) and heart failure (0.3% vs 2.7% vs 8.2%, p=0.001). The SS-II showed additive value on top of GRACE, anatomical SYNTAX score and residual SYNTAX score. Conclusions:The SS-II in patients with STEMI undergoing pPCI adds important prognostic information regarding midterm adverse outcomes, being an independent and powerful predictor of MACE, heart failure and all-cause mortality during follow-up.

The performance of SYNTAX score versus the coronary angiogram standard evaluation in the prediction of cardiovascular events in a cohort of patients with stable coronary heart disease

“…Clinical prognostic variables have been combined with the anatomical SXscore to increase the its accuracy to guide the choice between PCI and CABG for patients with multivessel coronary disease, such as the logistic clinical SYNTAX score (31)(32)(33)(34)(35), the CABG SYNTAX Score (36,37), the SYNTAX score II (38)(39)(40)(41), the SYNTAX score III (42,43), the residual SYNTAX score (44), and the clinical residual SYNTAX score (45). These more complex scores derived from the SYNTAX score have not gained practical application as well, and some of them have been less effective to predict outcomes than other functional predictors, such as the fractional flow reserve (FFR) (46,47).…”

Evaluation of the Prognostic Role of the Wall Motion Score Index and the SYNTAX Score II in Patients with Acute Coronary Syndrome Following Percutaneous Coronary Intervention by Evaluation of Major Adverse Cardiovascular Events at 12-Month Follow-Up

“…Nevertheless, studies showed that SSII had a stronger predictive effect for hospitalization and long-term mortality in hospitalized patients with both ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction than SS [ 7 , 17 , 18 ]. Other studies also elucidated that, the latter is more capable of evaluating complex CAD and even better than other risk-scoring systems including GRACE and TIMI scores [ 7 , 19 ], motivating us to further explore the role of SSII.…”

Long Term Prognostic Value Of SYNTAX Score II Among Stemi Patients—A Comprehensive Result From Meta-Analysis

“…Of these, 28 (13%) were potentially relevant articles for further review by title and abstract. After full text screening, 13 articles met the inclusion criteria; however, two studies [5,13] reported the same data, so only one [5] was included in the final meta-analysis (Figure 1). The characteristics of the 12 included studies are summaried in Table 1.…”

“…First, most of the studies were either of small sample size or were retrospective single centre studies. Second, the outcomes varied between the different studies, including major adverse cardiac events (MACE), heart failure and all-cause mortality [5][6][7][8][9][10][11][12]. Third, the effect size was inconsistent, including odds ratio (OR), hazard ratio (HR), risk ratio (RR) and other indicators.…”