Prognostic Value of the SYNTAX Score in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Palmerini, Tullio; Généreux, Philippe; Caixeta, Adriano; Cristea, Ecaterina; Lansky, Alexandra J.; Mehran, Roxana; Dangas, George; Lazar, Dana; Sanchez, Rachel L.; Fahy, Martin; Xu, Ke; Stone, Gregg W.

doi:10.1016/j.jacc.2011.02.032

Cited by 241 publications

(112 citation statements)

References 29 publications

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“…The SXscore is widely accepted as an independent prognostic marker in patients with ACS [2,3]. Palmerini et al [2] showed that the SXscore is an independent predictor of the one-year rates of death, cardiac death, myocardial infarction, and target vessel revascularisation in patients with NSTEACS undergoing percutaneous coronary intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Palmerini et al [2] showed that the SXscore is an independent predictor of the one-year rates of death, cardiac death, myocardial infarction, and target vessel revascularisation in patients with NSTEACS undergoing percutaneous coronary intervention. Magro et al [3] demonstrated that the SXscore during primary percutaneous coronary intervention is a useful tool that provides additional risk stratification to known risk factors of long-term mortality and major adverse cardiovascular events in patients with STEMI.…”

Section: Discussionmentioning

confidence: 99%

“…Higher SXscore are associated with more serious disease and worse prognosis in patients with acute coronary syndromes (ACS) [2,3]. It is well established that underlying processes such as inflammation, enhanced coagulant activity, and endothelial dysfunction are closely related to the initiation and progression of atherosclerosis [4,5].…”

Section: Introductionmentioning

confidence: 99%

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The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome

Kurtul¹,

Yarlıoğlueş

Murat

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: High Syntax score (SXscore) is associated with more serious disease and worse prognosis in patients with acute coronary syndrome (ACS). Plasma fibrinogen levels are associated with poor cardiovascular outcomes. Aim:To investigate the relation of admission fibrinogen levels with intermediate-high SXscore in patients with ACS. Methods:A total of 752 patients (61.6 ± 12.8 years, 67.3% men) with ACS, who underwent urgent coronary angiography (CAG) were enrolled. Laboratory data including fibrinogen and high sensitivity C-reactive protein were obtained before CAG. Syntax scores of all patients were calculated from baseline CAG. The patients were divided into two groups: low SXscore (≤ 22) and intermediate-high SXscore (≥ 23).Results: Admission fibrinogen levels were significantly higher in the SXscore ≥ 23 group when compared with the SXscore ≤ 22 group (median 492 mg/dL, interquartile range 428-581 mg/dL vs. median 370 mg/dL, interquartile range 309-428 mg/dL, respectively; p < 0.001). In multivariate analysis, the independent predictors of intermediate-high SXscore were fibrinogen (OR 1.008, 95% CI 1.005-1.010, p < 0.001), left ventricular ejection fraction (OR 0.935, p < 0.001), and age (OR 1.029, p = 0.041). A level of fibrinogen > 417 mg/dL had an 80.0% sensitivity and 71.3% specificity in predicting intermediate-high SXscore. Conclusions:Increased fibrinogen levels are independently associated with intermediate-high SXscore in patients with ACS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome

Kurtul¹,

Yarlıoğlueş

Murat

et al. 2016

Kardiol Pol

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“…Skala SYNTAX powstała jako użyteczne narzędzie do przewidywania zgonu, MI i rewaskularyzacji u pacjentów z NSTE-ACS poddawanych PCI. Skala ta może być przydatna w podejmowaniu decyzji o wyborze poszczególnych strategii rewaskularyzacji [381]. Wykonanie PCI zmiany odpowiedzialnej za niedokrwienie nie wymaga indywidualnej oceny i opinii kardiogrupy, jeśli są wskazania do wykonania interwencji ad hoc na podstawie danych klinicznych lub angiograficznych, takich jak: aktywne niedokrwienie, niestabilność hemodynamiczna, obrzęk płuc, nawracające arytmie komorowe lub całkowite zamknięcie tętnicy odpowiedzialnej za niedokrwienie, wymagające pilnej rewaskularyzacji.…”

Section: Przezskórne Interwencje Wieńcowe a Pomostowanie Aortalno-wieunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

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“…In this regard, the anatomical SS has been consistently shown to be an important tool for risk stratification. 1,[13][14][15][16][17][18] However, one of the most significant limitations of the SS is the omission of clinical variables in its calculation, which has been identified as a major effect in its capacity to accurately stratify patients with complex CAD. [19][20][21] The SS-II, by incorporating both the anatomic SS and clinical variables theoretically ensures a more accurate and individualized clinical outcome prediction.…”

Section: Discussionmentioning

confidence: 99%

SYNTAX Score-II Predicts Long-Term Mortality in Patients Who Underwent Left Main Percutaneous Coronary Intervention Treated With Second-Generation Drug-Eluting Stents

Zhao

et al. 2017

Int. Heart J.

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SummaryThe aim of this study was to evaluate the capacity of the SYNTAX Score-II (SS-II) to predict long-term mortality in patients undergoing left main percutaneous coronary intervention (LM-PCI) treated with second-generation drug-eluting stents (DES).Data from 487 consecutive patients with de novo left main coronary artery disease undergoing PCI were retrospectively studied. The patients were divided into tertiles according to the SS-II: low SS-II tertile (SS-II ≤ 22), intermediate SS-II tertile (SS-II of 23 to 30), and high SS-II tertile (SS-II ≥ 30). The survival curves were estimated by the KaplanMeier method. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the possible associations between the SS-II and the rates of long-term mortality. The predictive ability of the SS-II for mortality was assessed and compared with the SYNTAX score (SS) alone by an area under the receiver operator curve (AUC).The overall SS-II was 27.3 ± 9.1. At a mean follow-up of 5.1 years, the long-term mortality was 6.0%. The rates of mortality were 2.4%, 3.4%, and 11.6%, respectively (P < 0.0001) in the low, intermediate, and high SS-II tertiles. The cardiac mortality rates were 1.8%, 1.4%, and 8.1%, respectively (P = 0.002) among patients in the 3 groups. By multivariate analysis, SS-II was an independent predictor of the long-term mortality (hazard ratio: 1.56, 95% confidence interval: 1.05 to 2.32; P = 0.03). The AUC demonstrated a substantially higher predictive accuracy of the SS-II for mortality compared with the SS alone (AUC was 0.689 and 0.596, respectively).In patients with LM-PCI treated with a second-generation DES, the SS-II is an independent predictor of long-term mortality and demonstrates a superior predictability compared with the SS alone. (Int Heart J 2017; 58: 344-350) Key words: Left main coronary artery disease, Predict T he SYNTAX score II (SS-II) was recently developed by applying a Cox proportional hazards model to the results of the SYNTAX trial data. The SS-II incorporates a combination of two anatomical (anatomical SS and left main coronary artery disease) and 6 clinical variables (age, sex, left ventricular ejection fraction, creatinine clearance, chronic obstructive pulmonary disease, and peripheral vascular disease).1) The SS-II has been shown to provide reliable predictions of 4-year mortality for complex coronary artery disease (CAD), being internally validated in the landmark, all-comers, randomized SYNTAX trial 1,2) and externally applied in two real world registries.3,4) Therefore, the SS-II provides an impartial, evidence-based assessment of the decision-making process for clinicians weighing anatomical and clinical factors to establish the optimum revascularization technique for individual patients with complex CAD. However, all previous studies [1][2][3][4][5] about the validation of the SS-II have enrolled patients totally or mostly treated with a first-generation DES and some even used a small number of bare metal stents. At present, secon...

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Prognostic Value of the SYNTAX Score in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Abstract: In patients with non-ST-segment elevation acute coronary syndromes undergoing PCI, the SS is an independent predictor of the 1-year rates of death, cardiac death, MI, and TVR. (Comparison of Angiomax Versus Heparin in Acute Coronary Syndromes [ACS]; NCT00093158).

Cited by 241 publications

References 29 publications

The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome

The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

SYNTAX Score-II Predicts Long-Term Mortality in Patients Who Underwent Left Main Percutaneous Coronary Intervention Treated With Second-Generation Drug-Eluting Stents

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