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Functional SYNTAX Score for Risk Assessment in Multivessel Coronary Artery Disease

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Author(s)
Chang-Wook NamFabio MangiacapraRobert EntjesIn-Sung ChungJan-Willem SelsPim A. L. ToninoBernard De BruyneNico H. J. PijlsWilliam F. Fearon
Keimyung Author(s)
Nam, Chang WookChung, In Sung
Department
Dept. of Internal Medicine (내과학)
Dept. of Preventive Medicine (예방의학)
Journal Title
Journal of the American College of Cardiology
Issued Date
2011
Volume
58
Issue
12
Keyword
coronary angiographycoronary artery diseasefractional flow reservepercutaneous coronary interventionrisk assessment
Abstract
Objectives This study was aimed at investigating whether a fractional flow reserve (FFR)-guided SYNTAX score (SS), termed “functional SYNTAX score” (FSS), would predict clinical outcome better than the classic SS in patients with multivessel coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).
Background The SS is a purely anatomic score based on the coronary angiogram and predicts outcome after PCI in patients with multivessel CAD. FFR-guided PCI improves outcomes by adding functional information to the anatomic information obtained from the angiogram.
Methods The SS was prospectively collected in 497 patients enrolled in the FAME (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) study. FSS was determined by only counting ischemia-producing lesions (FFR ≤ 0.80). The ability of each score to predict major adverse cardiac events (MACE) at 1 year was compared.
Results The 497 patients were divided into tertiles of risk based on the SS. After determining the FSS for each patient, 32% moved to a lower-risk group as follows. MACE occurred in 9.0%, 11.3%, and 26.7% of patients in the low-, medium-, and high-FSS groups, respectively (p < 0.001). Only FSS and procedure time were independent predictors of 1-year MACE. FSS demonstrated a better predictive accuracy for MACE compared with SS (Harrell’s C of FSS, 0.677 vs. SS, 0.630, p = 0.02; integrated discrimination improvement of 1.94%, p < 0.001).
Conclusions Recalculating SS by only incorporating ischemia-producing lesions as determined by FFR decreases the number of higher-risk patients and better discriminates risk for adverse events in patients with multivessel CAD undergoing PCI.
Keimyung Author(s)(Kor)
남창욱
정인성
Publisher
School of Medicine
Citation
Chang-Wook Nam et al. (2011). Functional SYNTAX Score for Risk Assessment in Multivessel Coronary Artery Disease. Journal of the American College of Cardiology, 58(12), 1211–1218. doi: 10.1016/j.jacc.2011.06.020
Type
Article
ISSN
0735-1097
DOI
10.1016/j.jacc.2011.06.020
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33722
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학)
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