The Clinical Value of Syntax Scores in Predicting Coronary Artery Disease Outcomes

Aşkın, Lütfü

doi:10.15212/cvia.2022.0002

Cited by 8 publications

(9 citation statements)

References 53 publications

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“…However, SYNTAX scores also have some limitations. First, the SYNTAX score segmentation uses three equal thresholds, and the relationship between these thresholds and clinical outcomes is unclear [ 43 ]. Second, SYNTAX scores were not included in the assessment of clinical variables.…”

Section: Discussionmentioning

confidence: 99%

“…The SYNTAX II score predicts the prognosis of CAD patients more accurately and individually [ 45 ]. In addition, the Residual SYNTAX score was proposed to help select potential blood supply reconstruction strategies for patients with incomplete haemodialysis [ 43 ]. However, the SYNTAX II score and Residual SYNTAX score could not be analysed in depth in this study.…”

Section: Discussionmentioning

confidence: 99%

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Association of the triglyceride glucose-body mass index with the extent of coronary artery disease in patients with acute coronary syndromes

Yang,

Li,

Wen

et al. 2024

Cardiovasc Diabetol

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Background Studies have shown that insulin resistance is strongly associated with the development of cardiovascular disease, and the triglyceride glucose-body mass index (TyG-BMI index) is considered to be a reliable surrogate marker of insulin resistance. There are limited studies on the relationship between TyG-BMI index and the extent of coronary artery disease in patients with acute coronary syndrome (ACS). This study aimed to investigate the relationship between TyG-BMI index and the extent of coronary artery disease in patients with ACS. Methods Overall, 2,317 patients with ACS who underwent percutaneous coronary intervention at the Affiliated Hospital of Zunyi Medical University were included in this study. The TyG-BMI index was grouped according to the tertile method. The extent of coronary artery disease in patients with ACS was quantitatively assessed using the SYNTAX score, which was categorised as low (≤ 22), intermediate (23–32), and high risk (≥ 33). Results In the overall population, multivariate logistic regression analyses showed that TyG-BMI index was associated with mid/high SYNTAX score in patients with ACS (odds ratio [OR] = 1.0041; 95% confidence interval [CI] = 1.0000–1.0079; p = 0.0310). Subgroup analyses showed that TyG-BMI index was an independent risk factor for mid/high SYNTAX score in female ACS patients after adjusting for multiple confounders (OR = 1.0100; 95% CI = 1.0000–1.0200; p = 0.0050), and that the risk of mid/high SYNTAX score was 2.49 times higher in the T3 group (OR = 2.4900; 95% CI = 1.2200–5.0600; p = 0.0120). Restricted cubic spline analysis showed a linear correlation between TyG-BMI index and complex coronary artery disease (SYNTAX score > 22) in women with ACS. In female ACS patients, inclusion of the TyG-BMI index did not improve the predictive power of the underlying risk model (net reclassification improvement: 0.0867 [-0.0256–0.1989], p = 0.1301; integrated discrimination improvement: 0.0183 [0.0038–0.0329], p = 0.0135). Conclusions TyG-BMI index is linearly associated with the degree of complex coronary artery disease in female ACS patients. However, the inclusion of the TyG-BMI index did not improve the predictive power of the underlying risk model for female ACS patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of the triglyceride glucose-body mass index with the extent of coronary artery disease in patients with acute coronary syndromes

Yang,

Li,

Wen

et al. 2024

Cardiovasc Diabetol

View full text Add to dashboard Cite

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“…Coronary angiography cannot fully assess the significance of stenosis, as several factors (i.e., lesion length, shape, eccentricity, plaque characteristics, etc.) affect the degree of flow reduction 24,25 . Physiological assessment with FFR is the default approach to evaluate lesion hemodynamical significance 26 .…”

Section: Discussionmentioning

confidence: 99%

“…In the present meta-analysis of ) affect the degree of flow reduction. 24,25 Physiological assessment with FFR is the default approach to evaluate lesion hemodynamical significance. 26 IVI including IVUS and OCT not only allows characterization of lumen area and plaque morphology, but also can help to optimize PCI results.…”

Section: Discussionmentioning

confidence: 99%

Fractional flow reserve versus intravascular imaging to guide decision‐making for percutaneous coronary intervention in intermediate lesions: A meta‐analysis

Liu,

Zhang,

et al. 2023

Cathet Cardio Intervent

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BackgroundBoth fractional flow reserve (FFR) and intravascular imaging (IVI) have been used to guide the decision‐making for percutaneous coronary intervention (PCI) in intermediate coronary stenosis. Nevertheless, studies that directly compared the prognostic significance of these two strategies are scarce.AimsThe aim of this meta‐analyses was to evaluate the impact of FFR versus IVI to guide the decision‐making in PCI for intermediate stenosis on clinical outcomes.MethodsWe systematically searched PubMed, Embase, Cochrane, and relevant database from inception date to September 2022 for observational studies and randomized clinical trials (RCTs) which compared FFR and IVI‐based decision‐making in PCI for intermediate stenosis. The primary outcome was a composite of major adverse cardiac event (MACE). Pooled risk ratios (RR) were calculated using random effects models and heterogeneity were evaluated with the I2 statistic.ResultsWe identified 5 studies (3 RCTs and 2 observational studies) with 3208 patients. The follow‐up duration ranged from 12 to 24 months. Among five studies, four compared FFR with intravascular ultrasound while one compared FFR with optical coherence tomography. There was no statistically difference between FFR and IVI in the incidence of MACE (RR: 1.19; 95% confidence interval: 0.85–1.68; p = 0.31) and its individual components. These results were consistent regardless of various cut‐off value of PCI across the studies. Compared with IVI, FFR was associated with a lower PCI rate (37.0% vs. 60.3%; p < 0.001).ConclusionsThe decision to perform PCI for intermediate stenosis guided by FFR or IVI showed a similar clinical outcome. The use of FFR significantly reduced the need for PCI.

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“…3 ). As the value of SYNTAX scores in predicting clinical outcomes [ 20 ], we explored SYNTAX score II 2020 for predicting 10-year mortality in patients with RR. Similarly, we demonstrated that the majority of patients ( n = 295) having a RR have a higher rate of 10-year mortality after primary revascularization with PCI than CABG (Fig.…”

Section: Discussionmentioning

confidence: 99%

Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgical revascularization

et al. 2023

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Background The SYNTAX trial demonstrated negative impact of repeat revascularization (RR) on 5-year outcomes following PCI/CABG in patients with three-vessel(3VD) and/or left main coronary artery disease(LMCAD). We aimed to investigate the impact of RR within 5 years, on 10-year mortality in patients with 3VD and/or LMCAD after PCI/CABG. Methods The SYNTAXES study evaluated the vital status out to 10 years of patients with 3VD and/or LMCAD. Patients were stratified by RR within 5 years and randomized treatment. The association between RR within 5 years and 10-year mortality was assessed. Results A total of 330 out of 1800 patients (18.3%) underwent RR within 5 years. RR occurred more frequently after initial PCI than after initial CABG (25.9% vs. 13.7%, p < 0.001). Overall, 10-year mortality was comparable between patients undergoing RR and those not (28.2% vs. 26.1%, adjusted HR: 1.17, 95%CI 0.93–1.48, p = 0.187). In the PCI arm, RR was associated with a trend toward higher 10-year mortality (adjusted HR: 1.29, 95%CI 0.97–1.72, p = 0.075), while in the CABG arm, the trend was opposite (adjusted HR: 0.74, 95%CI 0.46–1.20, p = 0.219). Among patients requiring RR, those who underwent PCI as initial revascularization had a higher risk of 10-year mortality compared to initial CABG (33.5% vs. 17.6%, adjusted HR: 2.09, 95%CI 1.21–3.61, p = 0.008). Conclusion In the SYNTAXES study, RR within 5 years had no impact on 10-year all-cause death in the population overall. Among patients requiring any repeat procedures, 10-year mortality was higher after initial treatment with PCI than after CABG. These exploratory findings should be investigated with larger populations in future studies. Trial registration URL: https://www.clinicaltrials.gov; SYNTAXES Unique identifier: NCT03417050. URL: https://www.clinicaltrials.gov; SYNTAX Unique identifier: NCT00114972. Graphical abstract

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The Clinical Value of Syntax Scores in Predicting Coronary Artery Disease Outcomes

Cited by 8 publications

References 53 publications

Association of the triglyceride glucose-body mass index with the extent of coronary artery disease in patients with acute coronary syndromes

Association of the triglyceride glucose-body mass index with the extent of coronary artery disease in patients with acute coronary syndromes

Fractional flow reserve versus intravascular imaging to guide decision‐making for percutaneous coronary intervention in intermediate lesions: A meta‐analysis

Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgical revascularization

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