• J. Thorac. Cardiovasc. Surg. · Sep 2023

    Anatomical and clinical risk stratification tool for mortality risk assessment following revascularization for multivessel coronary artery disease.

    • Eilon Ram, Tohar Kassif, Yael Peled, Yigal Kassif, Roni Postan Koren, Leonid Sternik, and Ehud Raanani.
    • Department of Cardiac Surgery, Leviev Cardiothoracic and Vascular Center, Sheba Medical Center affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel; The Sheba Talpiot Medical Leadership Program, Ramat Gan, Israel. Electronic address: eilon.ram@sheba.health.gov.il.
    • J. Thorac. Cardiovasc. Surg. 2023 Sep 1; 166 (3): 793800.e5793-800.e5.

    ObjectiveThis study aimed to assess the prognostic ability of SYNTAX score II in left main and/or 3-vessel disease patients undergoing revascularization either by coronary artery bypass grafting or percutaneous coronary intervention in a national registry.MethodsThis prospective registry included consecutive patients with multivessel disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography. Of the 1112 study patients, 368 patients (33%) had a low (<25), 372 (33%) had an intermediate (25-35) and 372 patients (33%) a high (≥35) SYNTAX score II.ResultsPatients with a high SYNTAX score II had higher 30-day mortality compared with those with an intermediate or low SYNTAX score II (2.8% vs 0.6% vs 0% respectively, P = .001). Each 1-unit increment in SYNTAX score II increased the odds for death at 30 days by 11% (95% CI, 1.02-1.22; P = .026). Six-year mortality was higher among patients with a high compared with an intermediate or low SYNTAX score II (34.9% vs 11% vs 3.8%; log-rank P < .001). By adding a SYNTAX score II to standard prognostic factors, we showed a significant improvement of 40.1% (P < .001) for predicting 6-year mortality. The area under the curve of the SYNTAX score II (continuous) yielded 0.79 (95% CI, 0.75-0.82) in predicting 6-year mortality.ConclusionsOur findings show that the admission SYNTAX score II is a powerful marker of short- and long-term mortality, and therefore may be used as a risk stratification tool in patients with multivessel coronary artery disease who are candidates for revascularization.Copyright © 2021 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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