Validation and comparison of the long-term prognostic capability of the SYNTAX score-II among 1,528 consecutive patients who underwent left main percutaneous coronary intervention

Bo Xu, Philippe Genereux, Yuejin Yang, Martin B. Leon, Liang Xu, Shubin Qiao, Yongjian Wu, Hongbing Yan, Jilin Chen, Yelin Zhao, Yanyan Zhao, Tullio Palmerini, Gregg W. Stone, Runlin Gao

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objectives This study sought to evaluate the long-term prognostic capacity of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II (SS-II) and compare it with other risk scores among patients undergoing left main percutaneous coronary intervention (LM-PCI).

Background Recently, the SS-II was developed in an attempt to individualize and help the decision-making process between PCI and coronary artery bypass graft (CABG) surgery in the management of complex coronary artery disease (CAD). However, there is a paucity of data regarding the utility of SS-II in patients undergoing LM-PCI.

Methods Data from 1,528 consecutive patients from a single center undergoing unprotected LM-PCI were prospectively collected. The SS-II and other scores were then derived using patients' baseline clinical characteristics. Patients were stratified according to tertiles of SS-II for PCI: SS-II ≤21 (n = 508), SS-II >21 and ≤28 (n = 480), and ≥28 (n = 540). Predictive capability for long-term mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.

Results At a mean follow-up of 4.4 years, mortality in the first, second, and third SS-II tertiles was 1.8%, 3.5%, and 9.4%, respectively (p < 0.0001). Multivariate analysis showed SS-II to be a strong independent predictor of mortality (hazard ratio: 1.76, 95% confidence interval: 1.10 to 2.82; p = 0.02) after LM-PCI. When compared with the angiographic SS, scores combining both clinical and angiographic variables, such as the SS-II, were superior in terms of long-term prognostication.

Conclusions Results of this large series of consecutive patients who underwent unprotected LM-PCI suggested that the SS-II has better long-term prognostic power in terms of mortality compared with the original purely angiographic SS.

Original languageEnglish (US)
Pages (from-to)1128-1137
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume7
Issue number10
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Percutaneous Coronary Intervention
Mortality
Taxus
Coronary Artery Bypass
Thoracic Surgery
Coronary Artery Disease
Decision Making
Multivariate Analysis
Confidence Intervals
Transplants

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Xu, Bo ; Genereux, Philippe ; Yang, Yuejin ; Leon, Martin B. ; Xu, Liang ; Qiao, Shubin ; Wu, Yongjian ; Yan, Hongbing ; Chen, Jilin ; Zhao, Yelin ; Zhao, Yanyan ; Palmerini, Tullio ; Stone, Gregg W. ; Gao, Runlin. / Validation and comparison of the long-term prognostic capability of the SYNTAX score-II among 1,528 consecutive patients who underwent left main percutaneous coronary intervention. In: JACC: Cardiovascular Interventions. 2014 ; Vol. 7, No. 10. pp. 1128-1137.
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title = "Validation and comparison of the long-term prognostic capability of the SYNTAX score-II among 1,528 consecutive patients who underwent left main percutaneous coronary intervention",
abstract = "Objectives This study sought to evaluate the long-term prognostic capacity of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II (SS-II) and compare it with other risk scores among patients undergoing left main percutaneous coronary intervention (LM-PCI).Background Recently, the SS-II was developed in an attempt to individualize and help the decision-making process between PCI and coronary artery bypass graft (CABG) surgery in the management of complex coronary artery disease (CAD). However, there is a paucity of data regarding the utility of SS-II in patients undergoing LM-PCI.Methods Data from 1,528 consecutive patients from a single center undergoing unprotected LM-PCI were prospectively collected. The SS-II and other scores were then derived using patients' baseline clinical characteristics. Patients were stratified according to tertiles of SS-II for PCI: SS-II ≤21 (n = 508), SS-II >21 and ≤28 (n = 480), and ≥28 (n = 540). Predictive capability for long-term mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.Results At a mean follow-up of 4.4 years, mortality in the first, second, and third SS-II tertiles was 1.8{\%}, 3.5{\%}, and 9.4{\%}, respectively (p < 0.0001). Multivariate analysis showed SS-II to be a strong independent predictor of mortality (hazard ratio: 1.76, 95{\%} confidence interval: 1.10 to 2.82; p = 0.02) after LM-PCI. When compared with the angiographic SS, scores combining both clinical and angiographic variables, such as the SS-II, were superior in terms of long-term prognostication.Conclusions Results of this large series of consecutive patients who underwent unprotected LM-PCI suggested that the SS-II has better long-term prognostic power in terms of mortality compared with the original purely angiographic SS.",
author = "Bo Xu and Philippe Genereux and Yuejin Yang and Leon, {Martin B.} and Liang Xu and Shubin Qiao and Yongjian Wu and Hongbing Yan and Jilin Chen and Yelin Zhao and Yanyan Zhao and Tullio Palmerini and Stone, {Gregg W.} and Runlin Gao",
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Validation and comparison of the long-term prognostic capability of the SYNTAX score-II among 1,528 consecutive patients who underwent left main percutaneous coronary intervention. / Xu, Bo; Genereux, Philippe; Yang, Yuejin; Leon, Martin B.; Xu, Liang; Qiao, Shubin; Wu, Yongjian; Yan, Hongbing; Chen, Jilin; Zhao, Yelin; Zhao, Yanyan; Palmerini, Tullio; Stone, Gregg W.; Gao, Runlin.

In: JACC: Cardiovascular Interventions, Vol. 7, No. 10, 01.01.2014, p. 1128-1137.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Validation and comparison of the long-term prognostic capability of the SYNTAX score-II among 1,528 consecutive patients who underwent left main percutaneous coronary intervention

AU - Xu, Bo

AU - Genereux, Philippe

AU - Yang, Yuejin

AU - Leon, Martin B.

AU - Xu, Liang

AU - Qiao, Shubin

AU - Wu, Yongjian

AU - Yan, Hongbing

AU - Chen, Jilin

AU - Zhao, Yelin

AU - Zhao, Yanyan

AU - Palmerini, Tullio

AU - Stone, Gregg W.

AU - Gao, Runlin

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objectives This study sought to evaluate the long-term prognostic capacity of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II (SS-II) and compare it with other risk scores among patients undergoing left main percutaneous coronary intervention (LM-PCI).Background Recently, the SS-II was developed in an attempt to individualize and help the decision-making process between PCI and coronary artery bypass graft (CABG) surgery in the management of complex coronary artery disease (CAD). However, there is a paucity of data regarding the utility of SS-II in patients undergoing LM-PCI.Methods Data from 1,528 consecutive patients from a single center undergoing unprotected LM-PCI were prospectively collected. The SS-II and other scores were then derived using patients' baseline clinical characteristics. Patients were stratified according to tertiles of SS-II for PCI: SS-II ≤21 (n = 508), SS-II >21 and ≤28 (n = 480), and ≥28 (n = 540). Predictive capability for long-term mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.Results At a mean follow-up of 4.4 years, mortality in the first, second, and third SS-II tertiles was 1.8%, 3.5%, and 9.4%, respectively (p < 0.0001). Multivariate analysis showed SS-II to be a strong independent predictor of mortality (hazard ratio: 1.76, 95% confidence interval: 1.10 to 2.82; p = 0.02) after LM-PCI. When compared with the angiographic SS, scores combining both clinical and angiographic variables, such as the SS-II, were superior in terms of long-term prognostication.Conclusions Results of this large series of consecutive patients who underwent unprotected LM-PCI suggested that the SS-II has better long-term prognostic power in terms of mortality compared with the original purely angiographic SS.

AB - Objectives This study sought to evaluate the long-term prognostic capacity of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II (SS-II) and compare it with other risk scores among patients undergoing left main percutaneous coronary intervention (LM-PCI).Background Recently, the SS-II was developed in an attempt to individualize and help the decision-making process between PCI and coronary artery bypass graft (CABG) surgery in the management of complex coronary artery disease (CAD). However, there is a paucity of data regarding the utility of SS-II in patients undergoing LM-PCI.Methods Data from 1,528 consecutive patients from a single center undergoing unprotected LM-PCI were prospectively collected. The SS-II and other scores were then derived using patients' baseline clinical characteristics. Patients were stratified according to tertiles of SS-II for PCI: SS-II ≤21 (n = 508), SS-II >21 and ≤28 (n = 480), and ≥28 (n = 540). Predictive capability for long-term mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.Results At a mean follow-up of 4.4 years, mortality in the first, second, and third SS-II tertiles was 1.8%, 3.5%, and 9.4%, respectively (p < 0.0001). Multivariate analysis showed SS-II to be a strong independent predictor of mortality (hazard ratio: 1.76, 95% confidence interval: 1.10 to 2.82; p = 0.02) after LM-PCI. When compared with the angiographic SS, scores combining both clinical and angiographic variables, such as the SS-II, were superior in terms of long-term prognostication.Conclusions Results of this large series of consecutive patients who underwent unprotected LM-PCI suggested that the SS-II has better long-term prognostic power in terms of mortality compared with the original purely angiographic SS.

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