SYNTAX residual in long-term outcomes prognosis of endovascular revascularization in myocardial infarction with ST elevation and multivessel disease

Тарасов, Р. С.; Ганюков, В. И.; Ваккосов, К. М.; Барбараш, О. Л.; Барбараш, Л. С.

doi:10.15829/1728-8800-2016-5-33-38

Cited by 2 publications

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“…Количество баллов по шкале SYNTAX определяет комплексность поражения коронарного русла и может иметь значимое влияние на прогноз пациентов с острым ИМпST [25,26]. Тяжесть поражения по шкале SYNTAX имела сильную корреляцию с показателем летальности и частотой развития осложнений при ИМпST независимо от исходных клинических и временных характеристик, а также используемой реперфузионной стратегии [25].…”

Section: Discussionunclassified

“…Тяжесть поражения по шкале SYNTAX имела сильную корреляцию с показателем летальности и частотой развития осложнений при ИМпST независимо от исходных клинических и временных характеристик, а также используемой реперфузионной стратегии [25]. После реваскуляризации инфаркт-связанной артерии остаточное количество баллов по шкале SYNTAX ≥9 ассоциировалось с неблагоприятным отдаленным прогнозом [26]. В нашем анализе значение по шкале SYNTAX ≥16 баллов являлось предиктором госпитальной летальности.…”

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The risk score for in-hospital mortality in patients with ST-segment elevation myocardial infarction

et al. 2021

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Aim To develop a scale (score system) for predicting the individual risk of in-hospital death in patients with ST segment elevation acute myocardial infarction (STEMI) with an account of results of percutaneous coronary intervention (PCI).Material and methods The analysis used data of 1 649 sequential patients with STEMI included into the hospital registry of PCI from 2006 through 2017. To test the model predictability, the original sample was divided into two groups: a training group consisting of 1150 (70 %) patients and a test group consisting of 499 (30 %) patients. The training sample was used for computing an individual score. To this purpose, β-coefficients of each variable obtained at the last stage of the multivariate logistic regression model were subjected to linear transformation. The scale was verified using the test sample.Results Seven independent predictors of in-hospital death were determined: age ≥65 years, acute heart failure (Killip class III-IV), total myocardial ischemia time ≥180 min, anterior localization of myocardial infarction, failure of PCI, SYNTAX scale score ≥16, glycemia on admission ≥7.78 mmol/l for patients without a history of diabetes mellitus and ≥14.35 mmol/l for patients with a history of diabetes mellitus. The contribution of each value to the risk of in-hospital death was ranked from 0 to 7. A threshold total score of 10 was determined; a score ≥10 corresponded to a high probability of in-hospital death (18.2 %). In the training sample, the sensitivity was 81 %, the specificity was 80.6 %, and the area under the curve (AUC) was 0.902. In the test sample, the sensitivity was 96.2 %, the specificity was 83.3 %, and the AUC was 0.924.Conclusion The developed scale has a good predictive accuracy in identifying patients with acute STEMI who have a high risk of fatal outcome at the hospital stage.

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The risk score for in-hospital mortality in patients with ST-segment elevation myocardial infarction

et al. 2021

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Prognostic Value of Residual Coronary Artery Lesions on the SYNTAX Scale in Patients with Acute Myocardial Infarction without SТ Segment Elevation in the Mid-Term Period

et al. 2021

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Aim To study the effect of residual coronary injury after a percutaneous coronary intervention (PCI), as evaluated with the SYNTAX scale (residual SYNTAX score, RSS), on the mid-term prognosis for patients with non-ST elevation acute myocardial infarction (NSTEMI) and also to determine threshold RSS values for patients at high and low risk of adverse cardiac events.Material and methods A single-center, retrospective study was performed. From 421 patients with NSTEMI after PCI with stenting, 169 patients were selected who originally had multivessel coronary disease and who had undergone a repeated inpatient examination, including mid-term (11.7±3.0 mos.) coronary angiography. The endpoints were recurrent clinical manifestations of angina, repeat revascularization (RR), unstable angina (UA), recurrent acute myocardial infarction (AMI), cardiac death, and also a composite endpoint (major adverse cardiac events, MACE) that included UA, recurrent AMI, and cardiac death. After revealing a significant direct correlation between RSS and the probability of recurrent AMI, UA, MACE, or RR (p <0.05) using the ROC analysis, we have established threshold RSS values that divided patients into groups with high and low risk of the cardiac events listed above.Results For a significantly high risk of recurrent AMI (area under the curve, AUC 0.79±0.05; 95 % confidence interval, CI 0.68–0.89; р=0.048), the threshold RSS score was 8 (sensitivity 100 %, specificity 70.9 %). For UA and MACE, the RSS scores were both 3 (AUC 0.68±0.5; 95 % CI 0.58–0.79; p=0.005 and AUC 0.71±0.05; 95 % CI 0.61–0.8; p=0.001, respectively). The probability of UA during the observation period with RSS >3 was 4.07 times higher and that of MACE was 5.23 times higher than with RSS<3 (95 % CI 1.44–11.49; р=0.01 and 95 % CI 1.88–14.53; р=0.001, respectively).Conclusion The study demonstrated a significant, direct correlation between the RSS and the risk of adverse cardiac events in patients with NSTEMI during one year of observation. Specific threshold values were obtained, which may help in choosing both the extent of revascularization and the tactics for postoperative management of patients.

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SYNTAX residual in long-term outcomes prognosis of endovascular revascularization in myocardial infarction with ST elevation and multivessel disease

Cited by 2 publications

References 12 publications

The risk score for in-hospital mortality in patients with ST-segment elevation myocardial infarction

The risk score for in-hospital mortality in patients with ST-segment elevation myocardial infarction

Prognostic Value of Residual Coronary Artery Lesions on the SYNTAX Scale in Patients with Acute Myocardial Infarction without SТ Segment Elevation in the Mid-Term Period

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