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

Research output: Contribution to journalArticle

18 Citations (Scopus)

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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