Validity of SYNTAX score Ⅱ for risk stratification of percutaneous
coronary interventions: A patient-level pooled analysis of 5433
patients enrolled in contemporary coronary stent trials
- Author(s)
- Carlos M. Campos; Hector M. Garcia-Garcia; David van Klaveren; Yuki Ishibashi; Yun-Kyeong Cho; Marco Valgimigli; Lorenz Räber; Hans Jonker; Yoshinobu Onuma; Vasim Farooq; Scot Garg; Stephan Windecker; Marie-Angele Morel; Ewout W. Steyerberg; Patrick W. Serruys
- Keimyung Author(s)
- Cho, Yun Kyeong
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- International Journal of Cardiology
- Issued Date
- 2015
- Volume
- 187
- Abstract
- Objectives: To assess the clinical profile and long-term mortality in SYNTAX score II based strata of patients who
received percutaneous coronary interventions (PCI) in contemporary randomized trials.
Background: The SYNTAX score II was developed in the randomized, all-comers' SYNTAX trial population and is
composed by 2 anatomical and 6 clinical variables. The interaction of these variableswith the treatment provides
individual long-term mortality predictions if a patient undergoes coronary artery bypass grafting (CABG) or PCI.
Methods: Patient-level (n = 5433) data from 7 contemporary coronary drug-eluting stent (DES) trials were
pooled. The mortality for CABG or PCI was estimated for every patient. The difference in mortality estimates
for these two revascularization strategies was used to divide the patients into three groups of theoretical treatment
recommendations: PCI, CABG or PCI/CABG (the latter means equipoise between CABG and PCI for long
term mortality).
Results: The three groups hadmarked differences in their baseline characteristics. According to the predicted risk
differences, 5115 patients could be treated either by PCI or CABG, 271 should be treated only by PCI and, rarely,
CABG (n = 47) was recommended. At 3-year follow-up, according to the SYNTAX score II recommendations,
patients recommended for CABG had higher mortality compared to the PCI and PCI/CABG groups (17.4%; 6.1%
and 5.3%, respectively; P b 0.01).
Conclusions: The SYNTAX score II demonstrated capability to help in stratifying PCI procedures.
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