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Does SYNTAX score II predict poor myocardial perfusion in ST-segmen
1Department of cardiology, Xuanwu Hospital, Capital Medical University. huaqicardiologist@163.com.
Insights
High SYNTAX score II (SS-II) predicts poor myocardial perfusion (MBG 0/1) in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (pPCI). This finding aids in assessing STEMI patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Myocardial Infarction Research
Background:
- SYNTAX score II (SS-II) predicts outcomes in coronary artery disease but its role in ST-segment elevation myocardial infarction (STEMI) is unclear.
- Poor myocardial perfusion, indicated by myocardial blush grade (MBG) 0/1, negatively impacts STEMI prognosis after primary percutaneous coronary intervention (pPCI).
Purpose of the Study:
- To evaluate the prognostic value of SS-II in STEMI patients undergoing pPCI.
- To investigate the relationship between SS-II and MBG 0/1 in this patient population.
Main Methods:
- A total of 477 STEMI patients treated with pPCI were analyzed.
- SYNTAX score II and myocardial blush grade (MBG) were assessed; MBG was categorized as 0/1 (poor perfusion) or 2/3 (normal perfusion).
- Patients were stratified into three SS-II tertiles: low (≤20), intermediate (20-26), and high (≥26).
Main Results:
- The high SS-II tertile showed a significantly higher incidence of MBG 0/1 (46.1%) compared to intermediate (32.1%) and low (21.8%) tertiles (p < 0.001).
- Multivariate analysis confirmed SS-II as an independent predictor of MBG 0/1 (HR 1.084, p < 0.001).
- An SS-II cutoff value of >24 demonstrated optimal prediction for MBG 0/1 with 66% sensitivity and 54% specificity.
Conclusions:
- Elevated SS-II is an independent predictor of poor myocardial perfusion (MBG 0/1) in STEMI patients following pPCI.
- The SS-II may serve as a valuable tool for risk stratification in STEMI patients undergoing pPCI.
Background:
SYNTAX score II (SS-II) has been demonstrated to predict long-term outcomes in unprotected left main or multiple vessels in patients with coronary artery disease. However, its prognostic value for patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. The poor myocardial perfusion (myocardial blush grade [MBG] 0/1) after primary percutaneous coronary intervention (pPCI) has a negative prognostic value in patients with STEMI. We aimed to assess SS-II and its possible relationships with MBG 0/1 in patients with STEMI treated with pPCI.
Methods:
The study included 477 patients with STEMI who underwent pPCI between October 2010 and May 2014. SYNTAX Score II and MBG were determined in all patients. Myocardial blush grade were divided into MBG 0/1 (poor myocardial perfusion) and MBG 2/3 (normal myocardial perfusion). Patients were divided into three tertiles: SS-IIlow (￡ 20), SS-IIintermediate (20-26) and SS-IIhigh (≥ 26).
Results:
Compared with the SS-IIintermediate and SS-IIlow tertiles, the SS-IIhigh tertile had more MBG 0/1 (46.1%, 32.1% and 21.8%, p < 0.001, respectively). On multivariate logistic regression analysis, SS-II was an independent predictor of MBG 0/1 (hazard ratio 1.084, 95% confidence interval 1.050-1.119, p < 0.001). Receiver operating characteristic analysis identified SS-II > 24 as the best cut-off value predicting MBG 0/1 (sensitivity of 66%, specificity of 54%).
Conclusions:
High SS-II is an independent predictor of MBG 0/1 in patients with STEMI undergoing pPCI.
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