The Incremental Prognostic Value of the Clinical Residual SYNTAX Score for Patients With Chronic Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Yan, Luo; Li, Peiyao; Wang, Yabin; Han, Dongyi; Li, Sulei; Jiang, Min; Cao, Xin; Cao, Feng

doi:10.3389/fcvm.2021.647720

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Mounting epidemiological evidence suggests that insulin resistance constitutes an independent prognostic predictor in CAD [16], but insulin resistance or its surrogate marker has not been included in any risk prediction tools, such as the GRACE score or the SYNTAX score. Previous studies have shown that prediction models combining anatomical and clinical factors such as the SYN-TAX II score and clinical residual SYNTAX score could improve the discriminative ability for a better risk assessment [17][18][19]. One of our previous studies also highlighted that adjustment of the residual SYNTAX score by the TyG index significantly improves the predictive accuracy for adverse cardiovascular events in patients with type 2 diabetes mellitus undergoing PCI [11].…”

Section: Discussionmentioning

confidence: 83%

Association of the triglyceride–glucose index with coronary artery disease complexity in patients with acute coronary syndrome

Xiong

Chen

et al. 2023

Cardiovasc Diabetol

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Aim The triglyceride–glucose (TyG) index has been shown to be an independent predictor for the progression and prognosis of coronary artery disease (CAD). Whether the TyG index predicts the severity of CAD in patients presenting with acute coronary syndrome (ACS) remains unknown. Methods A total of 1,007 individuals presenting with ACS undergoing coronary angiography were stratified according to the tertiles of the TyG index and The Synergy Between Percutaneous Coronary Intervention (SYNTAX) score (SYNTAX score ≤ 22 versus SYNTAX score > 22). CAD complexity was determined by the SYNTAX score. Results After adjusting for multiple confounding factors, the TyG index was still an independent risk factor for mid/high SYNTAX scores (SYNTAX score > 22, OR 2.6452, 95% CI 1.9020–3.6786, P < 0.0001). Compared with the lowest tertile of the TyG (T1) group, the risk for a mid/high SYNTAX score in the T2 and T3 groups was 2.574-fold higher (OR, 2.574; 95% CI 1.610–4.112; P < 0.001) and 3.732-fold higher (OR, 3.732; 95% CI 2.330–5.975; P < 0.001), respectively. Furthermore, there was a dose‒response relationship between the TyG index and the risk of complicated CAD (SYNTAX score > 22; nonlinear P = 0.200). The risk for a mid/high SYNTAX score in the T2 and T3 groups was significantly higher in normoglycemia, prediabetes mellitus, and diabetes mellitus subgroups. Conclusions A higher TyG index was associated with the presence of a higher coronary anatomical complexity (SYNTAX score > 22) in ACS patients, irrespective of diabetes mellitus status. The TyG index might serve as a noninvasive predictor of CAD complexity in ACS patients and could potentially influence the management and therapeutic approach.

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Section: Discussionmentioning

confidence: 83%

Association of the triglyceride–glucose index with coronary artery disease complexity in patients with acute coronary syndrome

Xiong

Chen

et al. 2023

Cardiovasc Diabetol

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“…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).…”

Section: Discussionmentioning

confidence: 99%

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

Almeida¹,

Fuchs²,

Silva³

et al. 2022

Cardiovasc Diagn Ther

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Background: Scores for prediction of cardiovascular events in patients with stable coronary artery disease (CAD) submitted to coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI) or medical-therapy (MT), such as the SYNTAX score (SXscore), have been proposed, but there is no comparative assessment of their performance with the coronary angiogram standard evaluation (CASE).This study aimed to evaluate the performance of the SXscore versus the CASE in the prediction of major cardiovascular outcomes (MACCE) in patients with chronic CAD who were treated with MT or additionally submitted to CABG or PCI.Methods: Prospective cohort study of 454 patients with CAD referred for elective diagnostic coronary angiography in Hospital de Clínicas de Porto Alegre, Brazil, with 40 years of age or over, which were followed on average for 6±2.0 years. Patients with acute coronary syndromes, valvular heart disease, aortic diseases, previous coronary revascularization, heart failure, chronic renal disease, history of cancer, or severe psychiatric illness were excluded. Agreement between the scores was evaluated by Kappa statistics. The performance of the scores to predict MACCE was evaluated by Cox proportional hazard models. Areas under the ROC curves were compared by the DeLong test.Results: Patients with moderate to high SXscores or with left main or multivessel CAD (LMMCAD) in the CASE evaluation had higher rates of all-cause death and MACCE than those with low SXscore or without LMMCAD. After adjusting for confounding, only LMMCAD remained associated with the incidence of allcause death in the total sample (HR =2.81;95% CI: 1.17-6.74) and for MACCE in patients undergoing MT (HR =8.72; 95% CI: 1.73-44.10). The ROC curves for all treatments were similar. Kappa statistics was not significant in patients submitted to MT, poor for patients treated by PCI and fair for the whole sample and patients treated with CABG. Conclusions:The severity of CAD defined by CASE or the SXscore provides similar prediction of the occurrence of cardiovascular events in patients submitted to clinical, PCI or CABG therapies. CASE is easier to do and may be the preferential method in the stratification of risk of patients with stable CAD.

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“…The glomerular filtration rate was estimated for all patients utilizing the simplified Modification of Diet in Renal Disease method. As per our previous description, a subset of 2468 patients exhibited an assessed glomerular filtration rate (eGFR) of

90 mL/min/1.73

[ 10 , 11 ]. Among them, 1161 patients with left main and/or three-vessel CAD were present.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Capability of Clinical SYNTAX Score in Patients with Complex Coronary Artery Disease and Chronic Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Li,

Liu,

Jiang

et al. 2024

Rev. Cardiovasc. Med.

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Background: The SYNTAX score (SS) is useful for predicting clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). The clinical SYNTAX score (CSS), developed by combining clinical parameters with the SS, enhances the risk model’s ability to predict clinical outcomes. However, prior research has not yet evaluated the prognostic capacity of CSS in patients with complex coronary artery disease (CAD) and chronic renal insufficiency (CRI) who are undergoing PCI. We aimed to demonstrate the prognostic potential of CSS in assessing long-term adverse events in this high-risk patient cohort. Methods: A total of 962 patients with left main and/or three-vessel CAD and CRI were enrolled in the study spanning from January 2014 to September 2017. The CSS was calculated by multiplying the SS by the modified age, creatinine, and left ventricular ejection fraction (ACEF) score (age/ejection fraction + 1 for each 10 mL of creatinine clearance 60 mL/min per 1.73 ). The patients were categorized into three groups based on their CSS values: low-CSS group (CSS 18.0, n = 321), mid-CSS group (18.0 CSS 28.3, n = 317), and high-CSS group (CSS 28.3, n = 324) as per the tertiles of CSS. The primary endpoints were all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints included myocardial infarction (MI), unplanned revascularization, stroke, and major adverse cardiac and cerebrovascular events (MACCE). Results: At the median 3-year follow-up, the high-CSS group exhibited higher rates of ACM (19.4% vs. 6.6% vs. 3.6%, p 0.001), CM (15.6% vs. 5.1% vs. 3.2%, p = 0.003), and MACCE (33.8% vs. 29.0% vs. 20.0%, p = 0.005) in comparison to the low and mid-CSS groups. Multivariable Cox regression analysis revealed that CSS was an independent predictor for all primary and secondary endpoints ( p 0 .05). Moreover, the C-statistics of CSS for ACM (0.666 vs. 0.597, p = 0.021) and CM (0.668 vs. 0.592, p = 0.039) were significantly higher than those of SS. Conclusions: The clinical SYNTAX score substantially enhanced the prediction of median 3-year ACM and CM in comparison with SS in complex CAD and CRI patients following PCI.

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The Incremental Prognostic Value of the Clinical Residual SYNTAX Score for Patients With Chronic Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Cited by 5 publications

References 23 publications

Association of the triglyceride–glucose index with coronary artery disease complexity in patients with acute coronary syndrome

Association of the triglyceride–glucose index with coronary artery disease complexity in patients with acute coronary syndrome

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

Prognostic Capability of Clinical SYNTAX Score in Patients with Complex Coronary Artery Disease and Chronic Renal Insufficiency Undergoing Percutaneous Coronary Intervention

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