• Tolga Onuk, Bariş Güngör, Göktürk İpek, Mehmet B Karataş, Yiğit Çanga, Şükrü Akyüz, Recep Haci, Fatma Özpamuk Karadeniz, Aylin Sungur, Hülya Kaşikçioğlu, and Neşe Çam.
• aDepartment of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul bDepartment of Cardiology, Erzurum Training and Research Hospital, Erzurum cDepartment of Cardiology, Necip Fazil State Hospital, Kahramanmaras, Turkey.
• Coron. Artery Dis. 2016 Jun 1; 27 (4): 311-8.

BackgroundThe prognostic value of baseline SYNTAX (SS) and clinical SYNTAX (cSS) scores has been shown in different populations with coronary artery disease. However, their prognostic value has not been compared in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease.MethodsPatients who had undergone a primary percutaneous coronary intervention (PCI) for STEMI and had at least one critical lesion other than the culprit artery were recruited retrospectively. SS and cSS were calculated from medical records and angiograms and were compared in coronary artery by-pass grafting (CABG) and PCI groups. Long-term major adverse cardiac events (MACE) were defined as mortality, reinfarction, and target vessel revascularization.ResultsA total of 460 patients (214 in the CABG group and 246 in the PCI group) were analyzed. The baseline SS and the cSS were significantly higher in the CABG group compared with the PCI group (30.1±6.7 vs. 22.5±5.6; P<0.01 and 41.4±21.2 vs. 27.2±15.9; P<0.01, respectively). During a follow-up period of 32±8 months, 15 patients from the CABG group and 12 patients from the PCI group died (P=0.33), but the rate of MACE was higher in the PCI group (31 vs. 20%, P<0.01). Receiver operating curve analysis and univariate Cox regression analysis indicated that SS and cSS have prognostic value in the CABG group, but not in the PCI group. In the CABG group, SS and cSS showed significant discriminative power for long-term mortality (for SS>33 sensitivity 73.3%, specificity 71.4% and for cSS>38.4 sensitivity 93.3%, specificity 58.3%) and for MACE (for SS>34.5 sensitivity 50%, specificity 81.4% and for cSS>43.5 sensitivity 66.7%, specificity 73.8%).ConclusionSS and cSS scores have prognostic value in STEMI patients with multivessel disease treated with CABG surgery. cSS may be superior to SS for prediction of long-term adverse events in CABG patients.

34 keywords...

hide…