BACKGROUND: Whether SYNTAX score should be used as a stand-alone tool or whether its performance may be improved by the parallel use of clinical scores focusing on comorbidities, such as EuroSCORE, is a matter of debate. METHODS: A combined risk model including both clinical and angiographic information was developed, and its performance tested on a contemporary population of 255 patients with left main disease undergoing percutaneous coronary intervention (PCI). A global risk classification (GRC) system was created by combination of SYNTAX score and EuroSCORE strata, and new classes of risk were defined. RESULTS: When EuroSCORE was fitted into the SYNTAX score model, c-statistic increased from 0.681 to 0.732 for the prediction of cardiac mortality. The likelihood ratio test for the significance of adding the EuroSCORE term to the model was chi(2) = 4.109 (P = .043) with a net reclassification improvement of 26% (P = .002). GRC showed the best prediction and discriminative ability in terms of two-year cardiac mortality (HR 3.40, 95% CI 1.79-6.43, P < .001; c-statistic 0.756) as compared with SYNTAX score (HR 2.87, 95% CI 1.35-6.10, P = .006; c-statistic 0.747) and EuroSCORE (HR 3.04, 95% CI 1.41-6.57, P = .005; c-statistic 0.708) alone. CONCLUSIONS: We found a significant improvement in the prediction of cardiac mortality with the inclusion of EuroSCORE in a SYNTAX score-based model. The degree of reclassification between treatment threshold categories indicates that clinical and angiographic information are both important for assessing individual risk of patients undergoing left main PCI. Copyright 2010 Mosby, Inc. All rights reserved.
BACKGROUND: Whether SYNTAX score should be used as a stand-alone tool or whether its performance may be improved by the parallel use of clinical scores focusing on comorbidities, such as EuroSCORE, is a matter of debate. METHODS: A combined risk model including both clinical and angiographic information was developed, and its performance tested on a contemporary population of 255 patients with left main disease undergoing percutaneous coronary intervention (PCI). A global risk classification (GRC) system was created by combination of SYNTAX score and EuroSCORE strata, and new classes of risk were defined. RESULTS: When EuroSCORE was fitted into the SYNTAX score model, c-statistic increased from 0.681 to 0.732 for the prediction of cardiac mortality. The likelihood ratio test for the significance of adding the EuroSCORE term to the model was chi(2) = 4.109 (P = .043) with a net reclassification improvement of 26% (P = .002). GRC showed the best prediction and discriminative ability in terms of two-year cardiac mortality (HR 3.40, 95% CI 1.79-6.43, P < .001; c-statistic 0.756) as compared with SYNTAX score (HR 2.87, 95% CI 1.35-6.10, P = .006; c-statistic 0.747) and EuroSCORE (HR 3.04, 95% CI 1.41-6.57, P = .005; c-statistic 0.708) alone. CONCLUSIONS: We found a significant improvement in the prediction of cardiac mortality with the inclusion of EuroSCORE in a SYNTAX score-based model. The degree of reclassification between treatment threshold categories indicates that clinical and angiographic information are both important for assessing individual risk of patients undergoing left main PCI. Copyright 2010 Mosby, Inc. All rights reserved.
Authors: Giuseppe Biondi-Zoccai; Imad Sheiban; Claudio Moretti; Tullio Palmerini; Antonio Marzocchi; Davide Capodanno; Corrado Tamburino; Massimo Margheri; Giuseppe Vecchi; Giuseppe Sangiorgi; Andrea Santarelli; Antonio L Bartorelli; Carlo Briguori; Luigi Vignali; Francesco di Pede; Angelo Ramondo; Massimo Medda; Marco de Carlo; Giovanni Falsini; Alberto Benassi; Cataldo Palmieri; Vincenzo Filippone; Diego Sangiorgi; Fabio Barlocco; Stefano de Servi Journal: Clin Res Cardiol Date: 2010-12-03 Impact factor: 5.460
Authors: Jason C Kovacic; Atul M Limaye; Samantha Sartori; Paul Lee; Roshan Patel; Sweta Chandela; Biana Trost; Swathi Roy; Rafael Harari; Birju Narechania; Rucha Karajgikar; Michael C Kim; Prakash Krishnan; Pedro Moreno; Usman Baber; Roxana Mehran; George Dangas; Annapoorna S Kini; Samin K Sharma Journal: Catheter Cardiovasc Interv Date: 2013-07-01 Impact factor: 2.692
Authors: Christoph Sinning; Lars Lillpopp; Sebastian Appelbaum; Francisco Ojeda; Tanja Zeller; Renate Schnabel; Edith Lubos; Annika Jagodzinski; Till Keller; Thomas Munzel; Christoph Bickel; Stefan Blankenberg Journal: Clin Res Cardiol Date: 2013-03-23 Impact factor: 5.460