The Prognostic Utility of the SYNTAX Score on 1-Year Outcomes After Revascularization With Zotarolimus- and Everolimus-Eluting Stents

Garg, Scot; Serruys, Patrick W.; Silber, Sigmund; Wykrzykowska, Joanna J.; Geuns, Robert Jan van; Richardt, Gert; Buszman, Paweł; Kelbæk, Henning; Boven, A.J. van; Hofma, Sjoerd H.; Linke, Axel; Klauß, Volker; Wijns, William; Macaya, Carlos; Garot, Philippe; DiMario, Carlo; Manoharan, Ganesh; Kornowski, Ran; Ischinger, Thomas; Bartorelli, Antonio L.; Remortel, Eric van; Ronden, Jacintha E.; Windecker, Stephan

doi:10.1016/j.jcin.2011.01.008

Cited by 104 publications

(73 citation statements)

References 26 publications

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“…Kaplan-Meier survival curves of (A) patient-oriented composite endpoint (POCE) and (B) target-lesion failure (TLF). The cumulative survival curves for both POCE and TLF showed statistically significant differences between low-SS (0-8), mid-SS (8)(9)(10)(11)(12)(13)(14)(15)(16), and high-SS (>16) groups. SS, SYNTAX score.…”

Section: Discussionmentioning

confidence: 91%

Usefulness of the SYNTAX and Clinical SYNTAX Scores in Predicting Clinical Outcome After Unrestricted Use of Sirolimus- and Everolimus-Eluting Stents

Park

Kang

et al. 2013

Circ J

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Section: Discussionmentioning

confidence: 91%

Usefulness of the SYNTAX and Clinical SYNTAX Scores in Predicting Clinical Outcome After Unrestricted Use of Sirolimus- and Everolimus-Eluting Stents

Park

Kang

et al. 2013

Circ J

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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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“…However, the small number of the reported events and the fact that this analysis did not take into account the angiographic variables associated with clinical outcomes (i.e. the Syntax score, or the residual Syntax score) did not allow us to draw safe conclusions about the additive prognostic value of CTCA in this population [149][150][151][152].…”

Section: Expert Commentarymentioning

confidence: 95%

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Patel

Tarkin

Serruys

et al. 2017

Expert Review of Cardiovascular Therapy

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Introduction: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients. ARTICLE HISTORY

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The Prognostic Utility of the SYNTAX Score on 1-Year Outcomes After Revascularization With Zotarolimus- and Everolimus-Eluting Stents

Cited by 104 publications

References 26 publications

Usefulness of the SYNTAX and Clinical SYNTAX Scores in Predicting Clinical Outcome After Unrestricted Use of Sirolimus- and Everolimus-Eluting Stents

Usefulness of the SYNTAX and Clinical SYNTAX Scores in Predicting Clinical Outcome After Unrestricted Use of Sirolimus- and Everolimus-Eluting Stents

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

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

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