Validity of SYNTAX score II for risk stratification of percutaneous coronary interventions: A patient-level pooled analysis of 5,433 patients enrolled in contemporary coronary stent trials.

Campos, Carlos M; Garcia-Garcia, Hector M; van Klaveren, David; Ishibashi, Yuki; Cho, Yun-Kyeong; Valgimigli, Marco; Räber, Lorenz; Jonker, Hans; Onuma, Yoshinobu; Farooq, Vasim; Garg, Scot; Windecker, Stephan; Morel, Marie-Angele; Steyerberg, Ewout W; Serruys, Patrick W (2015). Validity of SYNTAX score II for risk stratification of percutaneous coronary interventions: A patient-level pooled analysis of 5,433 patients enrolled in contemporary coronary stent trials. International journal of cardiology, 187, pp. 111-115. Elsevier 10.1016/j.ijcard.2015.03.248

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OBJECTIVES To assess the clinical profile and long-term mortality in SYNTAX score II based strata of patients who received percutaneous coronary interventions (PCI) in contemporary randomized trials. BACKGROUND The SYNTAX score II was developed in the randomized, all-comers' SYNTAX trial population and is composed by 2 anatomical and 6 clinical variables. The interaction of these variables with the treatment provides individual long-term mortality predictions if a patient undergoes coronary artery bypass grafting (CABG) or PCI. METHODS Patient-level (n=5433) data from 7 contemporary coronary drug-eluting stent (DES) trials were pooled. The mortality for CABG or PCI was estimated for every patient. The difference in mortality estimates for these two revascularization strategies was used to divide the patients into three groups of theoretical treatment recommendations: PCI, CABG or PCI/CABG (the latter means equipoise between CABG and PCI for long term mortality). RESULTS The three groups had marked differences in their baseline characteristics. According to the predicted risk differences, 5115 patients could be treated either by PCI or CABG, 271 should be treated only by PCI and, rarely, CABG (n=47) was recommended. At 3-year follow-up, according to the SYNTAX score II recommendations, patients recommended for CABG had higher mortality compared to the PCI and PCI/CABG groups (17.4%; 6.1% and 5.3%, respectively; P<0.01). CONCLUSIONS The SYNTAX score II demonstrated capability to help in stratifying PCI procedures.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Räber, Lorenz and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Judith Liniger

Date Deposited:

25 Feb 2016 11:21

Last Modified:

25 Feb 2016 11:21

Publisher DOI:

10.1016/j.ijcard.2015.03.248

PubMed ID:

25828327

Uncontrolled Keywords:

Drug-eluting stent; Percutaneous coronary intervention; Risk stratification; SYNTAX score; SYNTAX score II

BORIS DOI:

10.7892/boris.75934

URI:

https://boris.unibe.ch/id/eprint/75934

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