• Erion Xhepa, Tomohisa Tada, Sebastian Kufner, Gjin Ndrepepa, Robert A Byrne, Johanna Kreutzer, Tareq Ibrahim, Klaus Tiroch, Marco Valgimigli, Ralf Tölg, Salvatore Cassese, Massimiliano Fusaro, Heribert Schunkert, Karl L Laugwitz, Julinda Mehilli, and Adnan Kastrati.
• Deutsches Herzzentrum, Technische Universität München, Munich, Germany.
• Catheter Cardiovasc Interv. 2017 Jan 1; 89 (1): 1-10.

ObjectivesTo evaluate the long-term prognostic value of risk scores in the setting of drug-eluting stent (DES) implantation for uLMCA.BackgroundData on the prognostic value of novel risk scores developed to select the most appropriate revascularization strategy in patients undergoing DES implantation for uLMCA disease are relatively limited.MethodsThe study represents a patient-level pooled analysis of the ISAR-LEFT-MAIN (607 patients randomized to paclitaxel-eluting or sirolimus-eluting stents) and the ISAR-LEFT-MAIN-2 (650 patients randomized to everolimus-eluting or zotarolimus-eluting stents) randomized trials. The Syntax Score (SxScore) as well the Syntax Score II (SS-II), the EuroSCORE and the Global Risk Classification (GRC) were calculated. The primary outcome was all-cause mortality.ResultsAt a mean follow-up of 3 years there were 160 deaths (12.7%). The death-incidence was significantly higher in the upper tertiles than in the intermediate or lower ones for all risk scores (log-rank test P < 0.01 for all comparisons). The discriminatory power of a multivariable model for prediction of 3-year mortality was significantly improved after the inclusion of EuroSCORE (adjusted area under the receiver operating characteristic (ROC) curve = 0.779, 95% confidence interval 0.747 to 0.810, P = 0.008), but not after the inclusion of SxScore, SS II, or GRC.ConclusionsIn patients undergoing DES implantation for uLMCA disease, all evaluated risk scores were able to stratify the mortality risk at long-term follow-up. EuroSCORE was the only risk score that significantly improved the discriminatory power of a multivariable model to predict long-term mortality. © 2016 Wiley Periodicals, Inc.© 2016 Wiley Periodicals, Inc.

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