BACKGROUND: The residual SYNTAX score (rSS) was designed and validated to quantify the burden of residual coronary artery disease after percutaneous coronary intervention (PCI). The aim of this study was to assess the prognostic impact of rSS in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease undergoing primary-PCI. METHODS: This retrospective cohort study included 1499 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2015. After exclusion criteria, the multivessel disease cohort (n=535) was divided into three groups, according to rSS: complete revascularization (rSS=0; n=198), reasonable incomplete revascularization (0<rSS<8; n=238) and incomplete revascularization (rSS≥8; n=99). RESULTS: In-hospital mortality was significantly lower in patients with complete and reasonable incomplete revascularization, when compared to those with incomplete revascularization (1.5% vs. 1.7% vs. 9.0%, p<0.001). During follow-up (median 2.4years), rSS was positively correlated with MACE (25.3% for rSS=0 vs. 31.1% for 0<rSS<8 vs. 47.0% for rSS≥8, p=0.001) and all-cause mortality (5.1% vs. 10.5% vs. 19.2%, p=0.001). The rSS was also an independent predictor of MACE (when compared with complete revascularization, odds ratio [OR] was 1.5 for reasonable incomplete and 1.8 for incomplete revascularization) and all-cause mortality during follow-up (OR 2.9 for reasonable incomplete and 3.9 for incomplete revascularization), adding prognostic value over control variables and GRACE. CONCLUSIONS: In a real-world cohort of patients with STEMI and multivessel disease who underwent PCI, the rSS added important prognostic information over control variables and GRACE, being an independent predictor of MACE and all-cause mortality during follow-up.
BACKGROUND: The residual SYNTAX score (rSS) was designed and validated to quantify the burden of residual coronary artery disease after percutaneous coronary intervention (PCI). The aim of this study was to assess the prognostic impact of rSS in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease undergoing primary-PCI. METHODS: This retrospective cohort study included 1499 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2015. After exclusion criteria, the multivessel disease cohort (n=535) was divided into three groups, according to rSS: complete revascularization (rSS=0; n=198), reasonable incomplete revascularization (0<rSS<8; n=238) and incomplete revascularization (rSS≥8; n=99). RESULTS: In-hospital mortality was significantly lower in patients with complete and reasonable incomplete revascularization, when compared to those with incomplete revascularization (1.5% vs. 1.7% vs. 9.0%, p<0.001). During follow-up (median 2.4years), rSS was positively correlated with MACE (25.3% for rSS=0 vs. 31.1% for 0<rSS<8 vs. 47.0% for rSS≥8, p=0.001) and all-cause mortality (5.1% vs. 10.5% vs. 19.2%, p=0.001). The rSS was also an independent predictor of MACE (when compared with complete revascularization, odds ratio [OR] was 1.5 for reasonable incomplete and 1.8 for incomplete revascularization) and all-cause mortality during follow-up (OR 2.9 for reasonable incomplete and 3.9 for incomplete revascularization), adding prognostic value over control variables and GRACE. CONCLUSIONS: In a real-world cohort of patients with STEMI and multivessel disease who underwent PCI, the rSS added important prognostic information over control variables and GRACE, being an independent predictor of MACE and all-cause mortality during follow-up.
Authors: Nuccia Morici; Gianfranco Alicandro; Luca A Ferri; Luigi Piatti; Daniele Grosseto; Paolo Sganzerla; Giovanni Tortorella; Maurizio Ferrario; Gabriele Crimi; Irene Bossi; Stefano Tondi; Anna Sonia Petronio; Matteo Mariani; Anna Toso; Amelia Ravera; Elena Corrada; Davide Cao; Leonardo Di Ascenzo; Carlo La Vecchia; Stefano De Servi; Stefano Savonitto Journal: CJC Open Date: 2020-03-20
Authors: Andreas Schäfer; Ralf Westenfeld; Jan-Thorben Sieweke; Andreas Zietzer; Julian Wiora; Giulia Masiero; Carolina Sanchez Martinez; Giuseppe Tarantini; Nikos Werner Journal: Front Cardiovasc Med Date: 2021-07-09
Authors: Anna E Bortnick; Sanyog G Shitole; Hayder Hashim; Pankaj Khullar; Michael Park; Michael Weinreich; Stephen Seibert; Judah Rauch; Giora Weisz; Jorge R Kizer Journal: Coron Artery Dis Date: 2022-05-01 Impact factor: 1.717