Impact of completeness of revascularization in complex coronary artery disease as measured with the SYNTAX revascularization index: An SEEDS Substudy

Bo Xu, Nicolas Bettinger, Changdong Guan, Björn Redfors, Yuejin Yang, Bao Li, Yaling Han, Xi Su, Zuyi Yuan, Philippe Généreux

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: We sought to study whether the level of completeness of revascularization as measured by the SYNTAX revascularization index (SRI) independently predicts adverse ischemic events after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES). Background: The SRI quantifies the proportion of revascularized myocardium. It has been shown to independently predict adverse ischemic events after PCI with first-generation DES. Methods: Among 1,900 patients enrolled in a registry to evaluate safety and effectiveness of everolimus drug-eluting stent (SEEDS) for coronary revascularization, the SRI was calculated and available for 1,851 patients. The patients were stratified into three groups according to the degree of revascularization (SRI = 100% [complete revascularization], SRI = 50 to <100%, and SRI <50%). Two-year mortality and major adverse cardiac events (MACE) were compared between the groups. Results: The SRI ranged from 4–100%, with a mean of 85.4%. Complete revascularization was achieved in 1,190 patients, while the SRI was 50% to <100% in 472 patients and <50% in 189 patients. Two-year mortality and MACE rates were higher in patients with lower SRI. ROC analysis showed an optimal SRI cutoff of 85% for predicting the 2-year mortality risk. An SRI ≥85% was associated with a similar risk of death to complete revascularization. The SRI independently predicted 2-year mortality and MACE. Conclusions: The SRI predicts mortality and adverse ischemic events in patients with complex CAD who underwent contemporary PCI with second-generation DES. Revascularizing ≥85% of the CAD burden was associated with a good prognosis and should be considered as a reasonable goal.

Original languageEnglish (US)
Pages (from-to)541-548
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume89
DOIs
StatePublished - Mar 1 2017

Fingerprint

Drug-Eluting Stents
Coronary Artery Disease
Safety
Percutaneous Coronary Intervention
Mortality
Everolimus
ROC Curve
Registries
Myocardium

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Xu, Bo ; Bettinger, Nicolas ; Guan, Changdong ; Redfors, Björn ; Yang, Yuejin ; Li, Bao ; Han, Yaling ; Su, Xi ; Yuan, Zuyi ; Généreux, Philippe. / Impact of completeness of revascularization in complex coronary artery disease as measured with the SYNTAX revascularization index : An SEEDS Substudy. In: Catheterization and Cardiovascular Interventions. 2017 ; Vol. 89. pp. 541-548.
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title = "Impact of completeness of revascularization in complex coronary artery disease as measured with the SYNTAX revascularization index: An SEEDS Substudy",
abstract = "Objectives: We sought to study whether the level of completeness of revascularization as measured by the SYNTAX revascularization index (SRI) independently predicts adverse ischemic events after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES). Background: The SRI quantifies the proportion of revascularized myocardium. It has been shown to independently predict adverse ischemic events after PCI with first-generation DES. Methods: Among 1,900 patients enrolled in a registry to evaluate safety and effectiveness of everolimus drug-eluting stent (SEEDS) for coronary revascularization, the SRI was calculated and available for 1,851 patients. The patients were stratified into three groups according to the degree of revascularization (SRI = 100{\%} [complete revascularization], SRI = 50 to <100{\%}, and SRI <50{\%}). Two-year mortality and major adverse cardiac events (MACE) were compared between the groups. Results: The SRI ranged from 4–100{\%}, with a mean of 85.4{\%}. Complete revascularization was achieved in 1,190 patients, while the SRI was 50{\%} to <100{\%} in 472 patients and <50{\%} in 189 patients. Two-year mortality and MACE rates were higher in patients with lower SRI. ROC analysis showed an optimal SRI cutoff of 85{\%} for predicting the 2-year mortality risk. An SRI ≥85{\%} was associated with a similar risk of death to complete revascularization. The SRI independently predicted 2-year mortality and MACE. Conclusions: The SRI predicts mortality and adverse ischemic events in patients with complex CAD who underwent contemporary PCI with second-generation DES. Revascularizing ≥85{\%} of the CAD burden was associated with a good prognosis and should be considered as a reasonable goal.",
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Impact of completeness of revascularization in complex coronary artery disease as measured with the SYNTAX revascularization index : An SEEDS Substudy. / Xu, Bo; Bettinger, Nicolas; Guan, Changdong; Redfors, Björn; Yang, Yuejin; Li, Bao; Han, Yaling; Su, Xi; Yuan, Zuyi; Généreux, Philippe.

In: Catheterization and Cardiovascular Interventions, Vol. 89, 01.03.2017, p. 541-548.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of completeness of revascularization in complex coronary artery disease as measured with the SYNTAX revascularization index

T2 - An SEEDS Substudy

AU - Xu, Bo

AU - Bettinger, Nicolas

AU - Guan, Changdong

AU - Redfors, Björn

AU - Yang, Yuejin

AU - Li, Bao

AU - Han, Yaling

AU - Su, Xi

AU - Yuan, Zuyi

AU - Généreux, Philippe

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objectives: We sought to study whether the level of completeness of revascularization as measured by the SYNTAX revascularization index (SRI) independently predicts adverse ischemic events after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES). Background: The SRI quantifies the proportion of revascularized myocardium. It has been shown to independently predict adverse ischemic events after PCI with first-generation DES. Methods: Among 1,900 patients enrolled in a registry to evaluate safety and effectiveness of everolimus drug-eluting stent (SEEDS) for coronary revascularization, the SRI was calculated and available for 1,851 patients. The patients were stratified into three groups according to the degree of revascularization (SRI = 100% [complete revascularization], SRI = 50 to <100%, and SRI <50%). Two-year mortality and major adverse cardiac events (MACE) were compared between the groups. Results: The SRI ranged from 4–100%, with a mean of 85.4%. Complete revascularization was achieved in 1,190 patients, while the SRI was 50% to <100% in 472 patients and <50% in 189 patients. Two-year mortality and MACE rates were higher in patients with lower SRI. ROC analysis showed an optimal SRI cutoff of 85% for predicting the 2-year mortality risk. An SRI ≥85% was associated with a similar risk of death to complete revascularization. The SRI independently predicted 2-year mortality and MACE. Conclusions: The SRI predicts mortality and adverse ischemic events in patients with complex CAD who underwent contemporary PCI with second-generation DES. Revascularizing ≥85% of the CAD burden was associated with a good prognosis and should be considered as a reasonable goal.

AB - Objectives: We sought to study whether the level of completeness of revascularization as measured by the SYNTAX revascularization index (SRI) independently predicts adverse ischemic events after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES). Background: The SRI quantifies the proportion of revascularized myocardium. It has been shown to independently predict adverse ischemic events after PCI with first-generation DES. Methods: Among 1,900 patients enrolled in a registry to evaluate safety and effectiveness of everolimus drug-eluting stent (SEEDS) for coronary revascularization, the SRI was calculated and available for 1,851 patients. The patients were stratified into three groups according to the degree of revascularization (SRI = 100% [complete revascularization], SRI = 50 to <100%, and SRI <50%). Two-year mortality and major adverse cardiac events (MACE) were compared between the groups. Results: The SRI ranged from 4–100%, with a mean of 85.4%. Complete revascularization was achieved in 1,190 patients, while the SRI was 50% to <100% in 472 patients and <50% in 189 patients. Two-year mortality and MACE rates were higher in patients with lower SRI. ROC analysis showed an optimal SRI cutoff of 85% for predicting the 2-year mortality risk. An SRI ≥85% was associated with a similar risk of death to complete revascularization. The SRI independently predicted 2-year mortality and MACE. Conclusions: The SRI predicts mortality and adverse ischemic events in patients with complex CAD who underwent contemporary PCI with second-generation DES. Revascularizing ≥85% of the CAD burden was associated with a good prognosis and should be considered as a reasonable goal.

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