Quantification and Impact of Untreated Coronary Artery Disease After Pci: The Residual Syntax Score

Généreux, Philippe; Palmerini, Tullio; Caixeta, Adriano; Rosner, Gregg; Dressler, Ovidiu; Dangas, George; Mehran, Roxana; Stone, Gregg W.

doi:10.1016/s0735-1097(12)60051-5

Cited by 89 publications

(154 citation statements)

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“…Po drugie, w licznych badaniach dotyczących PCI i NSTE-ACS wykazano niekorzystny wpływ rokowniczy niepełnej rewaskularyzacji. Zgodnie z tym dowiedziono, że rezydualny wynik > 8 w skali SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) jest niezależnie związany ze złym rokowaniem 30-dniowym i 1-rocznym, z uwzględnieniem wyższej śmiertelności po PCI u pacjentów z ACS umiarkowanego i wysokiego ryzyka [355,356]. W badaniach retrospektywnych wskazujących na gorsze wyniki u pacjentów niepoddanych pełnej rewaskularyzacji nie można wykluczyć istnienia niezmierzonych, istotnych czynników zakłócających te wyniki.…”

Section: Strategie Rewaskularyzacji I Wyniki Leczeniaunclassified

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

210

165

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Section: Strategie Rewaskularyzacji I Wyniki Leczeniaunclassified

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

210

165

View full text Add to dashboard Cite

“…21 The residual SYNTAX score was the unrevascularized score observed after PCI. Following PCI, only 40.4% of patients achieved CR with a residual SYNTAX score=0.…”

Section: Noninvasive Evaluationmentioning

confidence: 99%

Ischemia-Guided Percutaneous Coronary Intervention for Patients With Stable Coronary Artery Disease

Kim

Park

2013

Circ J

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“…Were it possible to identify differences in the extent of revascularization achieved in the 2 arms of the trial, this may partly explain the observed differences in all-cause mortality because more complete revascularization has previously been associated with improved long-term outcomes in stable coronary disease. 19,20 However, we have not found evidence of any systematic differences in the quality or amount of revascularization achieved with elective IABP therapy compared with a strategy of PCI without planned IABP use. Procedures were attempted in a similar number of vessels, with comparable rates of success, and a similarly high proportion of patients underwent PCI to proximal coronary segments such as the left main stem or proximal left anterior descending coronary artery in both groups.…”

Section: Discussionmentioning

confidence: 62%

Long-Term Mortality Data From the Balloon Pump–Assisted Coronary Intervention Study (BCIS-1)

et al. 2013

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I ntra-aortic balloon counterpulsation ameliorates ischemia by simultaneously augmenting coronary blood flow and reducing myocardial oxygen demand, making it a potentially valuable therapy for providing circulatory support in cardiogenic shock or preventing the occurrence of major complications during high-risk percutaneous coronary intervention (PCI). Singlecenter observational data had suggested a reduction in mortality and major complications with the use of an elective intra-aortic balloon pump (IABP) during high-risk PCI, 1,2 but the Balloon Pump-Assisted Coronary Intervention Study (BCIS-1) was the first randomized controlled evaluation of the safety and efficacy of counterpulsation during high-risk PCI.3 Compared with patients who had PCI without planned IABP support, those who received elective IABP insertion were found to have a similar incidence of major adverse cardiac and cerebrovascular events (MACCE) at hospital discharge, which is the primary outcome of the study. However, differences were observed in the major secondary outcomes of BCIS-1: the occurrence of procedural complications and all-cause mortality at 6 months. Procedural complications occurred much less frequently in patients who received elective IABP support, and fewer early deaths were noted in this group, although relatively few deaths had occurred at 6 months, and the difference in mortality was not statistically significant at that stage. Elective IABP use during high-risk PCI has a class IIb recommendation (level of evidence C) in the current American College of Cardiology Foundation/American Background-There is conflicting evidence on the utility of elective intra-aortic balloon pump (IABP) use during high-risk percutaneous coronary intervention (PCI). Observational series have indicated a reduction in major in-hospital adverse events, although randomized trial evidence does not support this. A recent study has suggested a mortality benefit trend early after PCI, but there are currently no long-term outcome data from randomized trials in this setting. Methods and Results-Three hundred one patients with left ventricular impairment (ejection fraction <30%) and severe coronary disease (BCIS-1 jeopardy score ≥8; maximum possible score=12) were randomized to receive PCI with elective IABP support (n=151) or without planned IABP support (n=150). Long-term all-cause mortality was assessed by tracking the databases held at the Office of National Statistics (in England and Wales) and the General Register Office (in Scotland). The groups were balanced in terms of baseline characteristics (left ventricular ejection fraction, 23.6%; BCIS-1 jeopardy score, 10.4) and the amount and type of revascularization performed. Mortality data were available for the entire cohort at a median of 51 months (interquartile range, 41-58) from randomization. All-cause mortality at follow-up was 33% in the overall cohort, with significantly fewer deaths occurring in the elective IABP group (n=42) than in the group that underwent PCI without planned IABP support ...

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Quantification and Impact of Untreated Coronary Artery Disease After Pci: The Residual Syntax Score

Cited by 89 publications

References 0 publications

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

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

Ischemia-Guided Percutaneous Coronary Intervention for Patients With Stable Coronary Artery Disease

Long-Term Mortality Data From the Balloon Pump–Assisted Coronary Intervention Study (BCIS-1)

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