SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: An ACUITY trial substudy

Mayank Yadav, Philippe Genereux, Tullio Palmerini, Adriano Caixeta, Mahesh V. Madhavan, Ke Xu, Sorin J. Brener, Roxana Mehran, Gregg W. Stone

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Abstract

Objective: We sought to investigate the relationship between the SYNTAX score (SS) and stent thrombosis (ST) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Background: The relationship between the SS and ST is undetermined. Methods: We stratified 2,627 patients undergoing PCI in the ACUITY trial by SS tertile according to the current population (true tertiles, SS <7, SS = 7-12, and SS >12) and by the SYNTAX trial (original SYNTAX tertiles, SS <23, SS = 23-32, and SS >32). Thirty-day and 1-year rates of definite/probable ST were determined for each tertile. Results: A total 30 (1.1%) and 41 (1.6%) definite/probable STevents occurred by 30 days and 1 year, respectively. When stratified by true tertiles, 30-day and 1-year rates of definite/probable STwere significantly greater in the highest tertile (SS >12; 2.0% and 2.8%) compared with the intermediate (SS = 7-12; 0.7% and 1.1%) and lowest tertiles (SS <7; 0.6% and 0.7%), P = 0.007 and P = 0.0009, respectively. When stratified by original SYNTAX tertiles, 30-day and 1-year rates of definite/probable ST were significantly greater in the highest (SS >32; 6.3% and 8.8%) and intermediate tertiles (SS = 23-32; 2.8% and 3.7%) compared with the lowest tertile (SS < 22; 0.8% and 1.2%), P <0.0001 for both. By multivariable analysis, the SS was an independent predictor for both 30-day and 1-year definite/probable ST. Conclusions: In patients with NSTE-ACS undergoing PCI, the extent and severity of CAD, as assessed by the SS before revascularization, was strongly associated with the occurrence of ST both at 30 days and 1 year.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalCatheterization and Cardiovascular Interventions
Volume85
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Percutaneous Coronary Intervention
Acute Coronary Syndrome
Stents
Thrombosis
Population

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Yadav, Mayank ; Genereux, Philippe ; Palmerini, Tullio ; Caixeta, Adriano ; Madhavan, Mahesh V. ; Xu, Ke ; Brener, Sorin J. ; Mehran, Roxana ; Stone, Gregg W. / SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes : An ACUITY trial substudy. In: Catheterization and Cardiovascular Interventions. 2015 ; Vol. 85, No. 1. pp. 1-10.
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title = "SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: An ACUITY trial substudy",
abstract = "Objective: We sought to investigate the relationship between the SYNTAX score (SS) and stent thrombosis (ST) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Background: The relationship between the SS and ST is undetermined. Methods: We stratified 2,627 patients undergoing PCI in the ACUITY trial by SS tertile according to the current population (true tertiles, SS <7, SS = 7-12, and SS >12) and by the SYNTAX trial (original SYNTAX tertiles, SS <23, SS = 23-32, and SS >32). Thirty-day and 1-year rates of definite/probable ST were determined for each tertile. Results: A total 30 (1.1{\%}) and 41 (1.6{\%}) definite/probable STevents occurred by 30 days and 1 year, respectively. When stratified by true tertiles, 30-day and 1-year rates of definite/probable STwere significantly greater in the highest tertile (SS >12; 2.0{\%} and 2.8{\%}) compared with the intermediate (SS = 7-12; 0.7{\%} and 1.1{\%}) and lowest tertiles (SS <7; 0.6{\%} and 0.7{\%}), P = 0.007 and P = 0.0009, respectively. When stratified by original SYNTAX tertiles, 30-day and 1-year rates of definite/probable ST were significantly greater in the highest (SS >32; 6.3{\%} and 8.8{\%}) and intermediate tertiles (SS = 23-32; 2.8{\%} and 3.7{\%}) compared with the lowest tertile (SS < 22; 0.8{\%} and 1.2{\%}), P <0.0001 for both. By multivariable analysis, the SS was an independent predictor for both 30-day and 1-year definite/probable ST. Conclusions: In patients with NSTE-ACS undergoing PCI, the extent and severity of CAD, as assessed by the SS before revascularization, was strongly associated with the occurrence of ST both at 30 days and 1 year.",
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SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes : An ACUITY trial substudy. / Yadav, Mayank; Genereux, Philippe; Palmerini, Tullio; Caixeta, Adriano; Madhavan, Mahesh V.; Xu, Ke; Brener, Sorin J.; Mehran, Roxana; Stone, Gregg W.

In: Catheterization and Cardiovascular Interventions, Vol. 85, No. 1, 01.01.2015, p. 1-10.

Research output: Contribution to journalArticle

TY - JOUR

T1 - SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes

T2 - An ACUITY trial substudy

AU - Yadav, Mayank

AU - Genereux, Philippe

AU - Palmerini, Tullio

AU - Caixeta, Adriano

AU - Madhavan, Mahesh V.

AU - Xu, Ke

AU - Brener, Sorin J.

AU - Mehran, Roxana

AU - Stone, Gregg W.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: We sought to investigate the relationship between the SYNTAX score (SS) and stent thrombosis (ST) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Background: The relationship between the SS and ST is undetermined. Methods: We stratified 2,627 patients undergoing PCI in the ACUITY trial by SS tertile according to the current population (true tertiles, SS <7, SS = 7-12, and SS >12) and by the SYNTAX trial (original SYNTAX tertiles, SS <23, SS = 23-32, and SS >32). Thirty-day and 1-year rates of definite/probable ST were determined for each tertile. Results: A total 30 (1.1%) and 41 (1.6%) definite/probable STevents occurred by 30 days and 1 year, respectively. When stratified by true tertiles, 30-day and 1-year rates of definite/probable STwere significantly greater in the highest tertile (SS >12; 2.0% and 2.8%) compared with the intermediate (SS = 7-12; 0.7% and 1.1%) and lowest tertiles (SS <7; 0.6% and 0.7%), P = 0.007 and P = 0.0009, respectively. When stratified by original SYNTAX tertiles, 30-day and 1-year rates of definite/probable ST were significantly greater in the highest (SS >32; 6.3% and 8.8%) and intermediate tertiles (SS = 23-32; 2.8% and 3.7%) compared with the lowest tertile (SS < 22; 0.8% and 1.2%), P <0.0001 for both. By multivariable analysis, the SS was an independent predictor for both 30-day and 1-year definite/probable ST. Conclusions: In patients with NSTE-ACS undergoing PCI, the extent and severity of CAD, as assessed by the SS before revascularization, was strongly associated with the occurrence of ST both at 30 days and 1 year.

AB - Objective: We sought to investigate the relationship between the SYNTAX score (SS) and stent thrombosis (ST) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Background: The relationship between the SS and ST is undetermined. Methods: We stratified 2,627 patients undergoing PCI in the ACUITY trial by SS tertile according to the current population (true tertiles, SS <7, SS = 7-12, and SS >12) and by the SYNTAX trial (original SYNTAX tertiles, SS <23, SS = 23-32, and SS >32). Thirty-day and 1-year rates of definite/probable ST were determined for each tertile. Results: A total 30 (1.1%) and 41 (1.6%) definite/probable STevents occurred by 30 days and 1 year, respectively. When stratified by true tertiles, 30-day and 1-year rates of definite/probable STwere significantly greater in the highest tertile (SS >12; 2.0% and 2.8%) compared with the intermediate (SS = 7-12; 0.7% and 1.1%) and lowest tertiles (SS <7; 0.6% and 0.7%), P = 0.007 and P = 0.0009, respectively. When stratified by original SYNTAX tertiles, 30-day and 1-year rates of definite/probable ST were significantly greater in the highest (SS >32; 6.3% and 8.8%) and intermediate tertiles (SS = 23-32; 2.8% and 3.7%) compared with the lowest tertile (SS < 22; 0.8% and 1.2%), P <0.0001 for both. By multivariable analysis, the SS was an independent predictor for both 30-day and 1-year definite/probable ST. Conclusions: In patients with NSTE-ACS undergoing PCI, the extent and severity of CAD, as assessed by the SS before revascularization, was strongly associated with the occurrence of ST both at 30 days and 1 year.

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