The SYNTAX score does not predict risk of adverse events in patients with non-ST elevation acute coronary syndrome who undergo coronary artery bypass graft surgery

Björn Redfors, Chun Hui He, Tullio Palmerini, Adriano Caixeta, Gennaro Giustino, Girma Minalu Ayele, Ajay J. Kirtane, Roxana Mehran, Gregg W. Stone, Philippe Genereux

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives. We tested the ability of the SYNTAX score (SS) to predict 1-year adverse outcomes for patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) who undergo coronary artery bypass graft (CABG) surgery. Background. The SS effectively risk stratifies patients who undergo percutaneous coronary intervention, but not patients with stable coronary disease who undergo CABG. Methods. We calculated the SS for 457 patients with NSTE-ACS in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial who underwent CABG. We stratified and compared patients according to SS tertiles. We tested the ability of the SS, as a linear covariate, to predict adverse events by univariate analyses and by univariate and multivariable Cox proportional hazards model. We also tested the predictive abilities of the Age, Creatinine Clearance, and Ejection Fraction (ACEF) score, the clinical SS, and the logistic clinical SS. Results. The median SS was 23 (interquartile range, 15-30). Baseline clinical characteristics were similar among the groups. One-year mortality and major adverse cardiovascular events (all-cause death, myocardial infarction, any stroke, or urgent revascularization) were similar between the groups (P=.13 and P=.62, respectively). Receiver operating characteristic curves, net reclassification indices, and integrated discrimination indices did not improve with SS, clinical SS, or logistic clinical SS compared with the ACEF score. Conclusions. The anatomical SS does not appear to be useful in risk stratifying patients with NSTE-ACS who undergo CABG. Clinical variables may better risk stratify patients with complex coronary artery disease considered for CABG.

Original languageEnglish (US)
Pages (from-to)42-49
Number of pages8
JournalJournal of Invasive Cardiology
Volume29
Issue number2
StatePublished - Feb 1 2017
Externally publishedYes

Fingerprint

Acute Coronary Syndrome
Coronary Artery Bypass
Transplants
Creatinine
Triage
Percutaneous Coronary Intervention
Proportional Hazards Models
ROC Curve
Catheterization
Coronary Disease
Coronary Artery Disease
Cause of Death
Stroke
Myocardial Infarction
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Redfors, Björn ; He, Chun Hui ; Palmerini, Tullio ; Caixeta, Adriano ; Giustino, Gennaro ; Ayele, Girma Minalu ; Kirtane, Ajay J. ; Mehran, Roxana ; Stone, Gregg W. ; Genereux, Philippe. / The SYNTAX score does not predict risk of adverse events in patients with non-ST elevation acute coronary syndrome who undergo coronary artery bypass graft surgery. In: Journal of Invasive Cardiology. 2017 ; Vol. 29, No. 2. pp. 42-49.
@article{7034a00fdea74aa5b7d269433897f91c,
title = "The SYNTAX score does not predict risk of adverse events in patients with non-ST elevation acute coronary syndrome who undergo coronary artery bypass graft surgery",
abstract = "Objectives. We tested the ability of the SYNTAX score (SS) to predict 1-year adverse outcomes for patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) who undergo coronary artery bypass graft (CABG) surgery. Background. The SS effectively risk stratifies patients who undergo percutaneous coronary intervention, but not patients with stable coronary disease who undergo CABG. Methods. We calculated the SS for 457 patients with NSTE-ACS in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial who underwent CABG. We stratified and compared patients according to SS tertiles. We tested the ability of the SS, as a linear covariate, to predict adverse events by univariate analyses and by univariate and multivariable Cox proportional hazards model. We also tested the predictive abilities of the Age, Creatinine Clearance, and Ejection Fraction (ACEF) score, the clinical SS, and the logistic clinical SS. Results. The median SS was 23 (interquartile range, 15-30). Baseline clinical characteristics were similar among the groups. One-year mortality and major adverse cardiovascular events (all-cause death, myocardial infarction, any stroke, or urgent revascularization) were similar between the groups (P=.13 and P=.62, respectively). Receiver operating characteristic curves, net reclassification indices, and integrated discrimination indices did not improve with SS, clinical SS, or logistic clinical SS compared with the ACEF score. Conclusions. The anatomical SS does not appear to be useful in risk stratifying patients with NSTE-ACS who undergo CABG. Clinical variables may better risk stratify patients with complex coronary artery disease considered for CABG.",
author = "Bj{\"o}rn Redfors and He, {Chun Hui} and Tullio Palmerini and Adriano Caixeta and Gennaro Giustino and Ayele, {Girma Minalu} and Kirtane, {Ajay J.} and Roxana Mehran and Stone, {Gregg W.} and Philippe Genereux",
year = "2017",
month = "2",
day = "1",
language = "English (US)",
volume = "29",
pages = "42--49",
journal = "Journal of Invasive Cardiology",
issn = "1042-3931",
publisher = "HMP Communications",
number = "2",

}

Redfors, B, He, CH, Palmerini, T, Caixeta, A, Giustino, G, Ayele, GM, Kirtane, AJ, Mehran, R, Stone, GW & Genereux, P 2017, 'The SYNTAX score does not predict risk of adverse events in patients with non-ST elevation acute coronary syndrome who undergo coronary artery bypass graft surgery', Journal of Invasive Cardiology, vol. 29, no. 2, pp. 42-49.

The SYNTAX score does not predict risk of adverse events in patients with non-ST elevation acute coronary syndrome who undergo coronary artery bypass graft surgery. / Redfors, Björn; He, Chun Hui; Palmerini, Tullio; Caixeta, Adriano; Giustino, Gennaro; Ayele, Girma Minalu; Kirtane, Ajay J.; Mehran, Roxana; Stone, Gregg W.; Genereux, Philippe.

In: Journal of Invasive Cardiology, Vol. 29, No. 2, 01.02.2017, p. 42-49.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The SYNTAX score does not predict risk of adverse events in patients with non-ST elevation acute coronary syndrome who undergo coronary artery bypass graft surgery

AU - Redfors, Björn

AU - He, Chun Hui

AU - Palmerini, Tullio

AU - Caixeta, Adriano

AU - Giustino, Gennaro

AU - Ayele, Girma Minalu

AU - Kirtane, Ajay J.

AU - Mehran, Roxana

AU - Stone, Gregg W.

AU - Genereux, Philippe

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Objectives. We tested the ability of the SYNTAX score (SS) to predict 1-year adverse outcomes for patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) who undergo coronary artery bypass graft (CABG) surgery. Background. The SS effectively risk stratifies patients who undergo percutaneous coronary intervention, but not patients with stable coronary disease who undergo CABG. Methods. We calculated the SS for 457 patients with NSTE-ACS in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial who underwent CABG. We stratified and compared patients according to SS tertiles. We tested the ability of the SS, as a linear covariate, to predict adverse events by univariate analyses and by univariate and multivariable Cox proportional hazards model. We also tested the predictive abilities of the Age, Creatinine Clearance, and Ejection Fraction (ACEF) score, the clinical SS, and the logistic clinical SS. Results. The median SS was 23 (interquartile range, 15-30). Baseline clinical characteristics were similar among the groups. One-year mortality and major adverse cardiovascular events (all-cause death, myocardial infarction, any stroke, or urgent revascularization) were similar between the groups (P=.13 and P=.62, respectively). Receiver operating characteristic curves, net reclassification indices, and integrated discrimination indices did not improve with SS, clinical SS, or logistic clinical SS compared with the ACEF score. Conclusions. The anatomical SS does not appear to be useful in risk stratifying patients with NSTE-ACS who undergo CABG. Clinical variables may better risk stratify patients with complex coronary artery disease considered for CABG.

AB - Objectives. We tested the ability of the SYNTAX score (SS) to predict 1-year adverse outcomes for patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) who undergo coronary artery bypass graft (CABG) surgery. Background. The SS effectively risk stratifies patients who undergo percutaneous coronary intervention, but not patients with stable coronary disease who undergo CABG. Methods. We calculated the SS for 457 patients with NSTE-ACS in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial who underwent CABG. We stratified and compared patients according to SS tertiles. We tested the ability of the SS, as a linear covariate, to predict adverse events by univariate analyses and by univariate and multivariable Cox proportional hazards model. We also tested the predictive abilities of the Age, Creatinine Clearance, and Ejection Fraction (ACEF) score, the clinical SS, and the logistic clinical SS. Results. The median SS was 23 (interquartile range, 15-30). Baseline clinical characteristics were similar among the groups. One-year mortality and major adverse cardiovascular events (all-cause death, myocardial infarction, any stroke, or urgent revascularization) were similar between the groups (P=.13 and P=.62, respectively). Receiver operating characteristic curves, net reclassification indices, and integrated discrimination indices did not improve with SS, clinical SS, or logistic clinical SS compared with the ACEF score. Conclusions. The anatomical SS does not appear to be useful in risk stratifying patients with NSTE-ACS who undergo CABG. Clinical variables may better risk stratify patients with complex coronary artery disease considered for CABG.

UR - http://www.scopus.com/inward/record.url?scp=85011360832&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011360832&partnerID=8YFLogxK

M3 - Article

C2 - 27974670

AN - SCOPUS:85011360832

VL - 29

SP - 42

EP - 49

JO - Journal of Invasive Cardiology

JF - Journal of Invasive Cardiology

SN - 1042-3931

IS - 2

ER -