Usefulness of the SYNTAX score to predict acute kidney injury after percutaneous coronary intervention (from the acute catheterization and urgent intervention triage strategy trial)

Mahesh V. Madhavan, Philippe Genereux, Jonah Rubin, Tullio Palmerini, Adriano Caixeta, Ke Xu, Giora Weisz, Roxana Mehran, Gregg W. Stone

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The synergy between percutaneous coronary intervention (PCI) with Taxus and cardiac surgery (SYNTAX) score (SS) has prognostic utility for ischemic outcomes in patients undergoing PCI. Acute kidney injury (AKI) after PCI has been demonstrated to be associated with adverse outcomes. However, the relation between the SS and AKI after PCI has yet to be fully investigated. We therefore sought to study this relation in the formal angiographic substudy of the large Acute Catheterization and Urgent Intervention Triage Strategy trial. We stratified 2,268 patients who underwent PCI for non-ST-segment elevation acute coronary syndromes by postprocedural AKI status and by SS tertiles (SS <7, 7 to 12, and >12). We also assessed rates of in-hospital, 30-day, and 1-year adverse outcomes. A total of 226 patients (10%) developed AKI, and rates in the highest Acute Catheterization and Urgent Intervention Triage Strategy SS tertile (>12) were significantly greater than those in the intermediate (7 to 12) and lowest tertiles (<7; 13% vs 8.9% vs 7.7%, respectively, p = 0.002). By multivariable analysis, the SS was independently associated with AKI (odds ratio per 10 SS points 1.22, 95% confidence interval 1.04 to 1.43, p = 0.02. Rates of major adverse cardiovascular events and net adverse clinical events increased significantly by SS tertile and were more common in patients who developed AKI. Patients who developed AKI experienced higher in-hospital, 30-day, and 1-year rates of mortality. In this large study, the SS was independently associated with AKI after PCI for non-ST-segment elevation acute coronary syndromes, and patients who developed AKI experienced worse short-term and long-term outcomes.

Original languageEnglish (US)
Pages (from-to)1331-1337
Number of pages7
JournalAmerican Journal of Cardiology
Volume113
Issue number8
DOIs
StatePublished - Apr 15 2014
Externally publishedYes

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Triage
Percutaneous Coronary Intervention
Acute Kidney Injury
Catheterization
Acute Coronary Syndrome
Taxus
Thoracic Surgery
Odds Ratio
Confidence Intervals
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Madhavan, Mahesh V. ; Genereux, Philippe ; Rubin, Jonah ; Palmerini, Tullio ; Caixeta, Adriano ; Xu, Ke ; Weisz, Giora ; Mehran, Roxana ; Stone, Gregg W. / Usefulness of the SYNTAX score to predict acute kidney injury after percutaneous coronary intervention (from the acute catheterization and urgent intervention triage strategy trial). In: American Journal of Cardiology. 2014 ; Vol. 113, No. 8. pp. 1331-1337.
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Usefulness of the SYNTAX score to predict acute kidney injury after percutaneous coronary intervention (from the acute catheterization and urgent intervention triage strategy trial). / Madhavan, Mahesh V.; Genereux, Philippe; Rubin, Jonah; Palmerini, Tullio; Caixeta, Adriano; Xu, Ke; Weisz, Giora; Mehran, Roxana; Stone, Gregg W.

In: American Journal of Cardiology, Vol. 113, No. 8, 15.04.2014, p. 1331-1337.

Research output: Contribution to journalArticle

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AU - Madhavan, Mahesh V.

AU - Genereux, Philippe

AU - Rubin, Jonah

AU - Palmerini, Tullio

AU - Caixeta, Adriano

AU - Xu, Ke

AU - Weisz, Giora

AU - Mehran, Roxana

AU - Stone, Gregg W.

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