Validation and comparison of the long-term prognostic capability of the SYNTAX score-II among 1,528 consecutive patients who underwent left main percutaneous coronary intervention

Bo Xu, Philippe Généreux, Yuejin Yang, Martin B. Leon, Liang Xu, Shubin Qiao, Yongjian Wu, Hongbing Yan, Jilin Chen, Yelin Zhao, Yanyan Zhao, Tullio Palmerini, Gregg W. Stone, Runlin Gao

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Objectives This study sought to evaluate the long-term prognostic capacity of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II (SS-II) and compare it with other risk scores among patients undergoing left main percutaneous coronary intervention (LM-PCI).

Background Recently, the SS-II was developed in an attempt to individualize and help the decision-making process between PCI and coronary artery bypass graft (CABG) surgery in the management of complex coronary artery disease (CAD). However, there is a paucity of data regarding the utility of SS-II in patients undergoing LM-PCI.

Methods Data from 1,528 consecutive patients from a single center undergoing unprotected LM-PCI were prospectively collected. The SS-II and other scores were then derived using patients' baseline clinical characteristics. Patients were stratified according to tertiles of SS-II for PCI: SS-II ≤21 (n = 508), SS-II >21 and ≤28 (n = 480), and ≥28 (n = 540). Predictive capability for long-term mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.

Results At a mean follow-up of 4.4 years, mortality in the first, second, and third SS-II tertiles was 1.8%, 3.5%, and 9.4%, respectively (p < 0.0001). Multivariate analysis showed SS-II to be a strong independent predictor of mortality (hazard ratio: 1.76, 95% confidence interval: 1.10 to 2.82; p = 0.02) after LM-PCI. When compared with the angiographic SS, scores combining both clinical and angiographic variables, such as the SS-II, were superior in terms of long-term prognostication.

Conclusions Results of this large series of consecutive patients who underwent unprotected LM-PCI suggested that the SS-II has better long-term prognostic power in terms of mortality compared with the original purely angiographic SS.

Original languageEnglish
Pages (from-to)1128-1137
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume7
Issue number10
DOIs
StatePublished - 1 Oct 2014
Externally publishedYes

Keywords

  • SYNTAX score
  • SYNTAX score II
  • coronary artery bypass grafting
  • left main
  • percutaneous coronary intervention

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