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Usefulness of the SYNTAX score II to predict 1-year outcome in patients with primary percutaneous coronary intervention

Wang, Gang; Wang, Chen; Zhang, Yuhui; Wang, Peng; Ran, Chenguang; Zhao, Lei; Han, Lixian

doi: 10.1097/MCA.0000000000000385
Original Research
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Objective This study aimed to investigate the predictive effect of SYNTAX score II (SS-II) for the 1-year outcome in patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention and whether SS-II improves the ability of anatomical and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events to predict major adverse cardiac events (MACE).

Background SS-II can predict 1-year outcomes in patients with complex coronary artery disease. However, the prognostic value of SS-II for patients undergoing primary percutaneous coronary intervention remains unclear.

Materials and methods A total of 477 patients were divided into three groups on the basis of SS-II [SS-II low tertile <20 (n=161), 20 ≤SS-II intermediate tertile ≤26 (n=145), and SS-II high tertile >26 (n=171)]. Kaplan–Meier methods were used to compare the MACE at the 1-year follow-up.

Results MACE was highest in the SS-II high tertile (21.1 vs. 10.3 vs. 5.5%, P<0.001), including all-cause mortality (11.7 vs. 4.1 vs. 2.5%, P=0.001), target vessel revascularization (7.6 vs. 4.1 vs. 1.8%, P=0.037), and recurrent MI (5.8 vs. 2.1 vs. 1.2%, P=0.035), compared with SS-II intermediate and low tertiles. In Cox multivariable analysis, SS-II was an independent predictor for MACE at 1 year. The receiver operating characteristic curve showed that SS-II had 60% sensitivity and 78% specificity for predicting 1-year MACE as a cut-off value of 27.5. The respective C-statistics of SS-II, anatomical, and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events for MACE were 0.726, 0.587, 0.684, and 0.628 (P<0.05).

Conclusion SS-II can predict 1-year clinical outcomes in patients with ST-segment elevation myocardial infarction and has an improved ability to predict MACE.

Departments of aCardiology

bCardiac Surgery, Cangzhou Central Hospital, Hebei Medical University

cDepartment of Clinical Laboratory, Cangzhou People’s Hospital, Canghou City, China

Correspondence to Gang Wang, MD, Department of Cardiology, Cangzhou Central Hospital, Hebei Medical University, No.16, Xinhua West Road, Cangzhou City 061001, China Tel: +86 151 031 72288; fax: +86 031 720 75507; e-mail: wanggangcto@163.com

Received February 16, 2016

Received in revised form April 10, 2016

Accepted April 18, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.