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A multidirectional approach to risk assessment in patients with three-vessel coronary artery disease undergoing

Toshikazu Kashiyama1, Satoru Otsuji1, Shin Takiuchi1

  • 1Department of Cardiology, Higashi Takarazuka Satoh Hospital, Hyogo, Japan.

Journal of Cardiology
|July 20, 2016
PubMed

Insights

The Clinical SYNTAX score (CSS) better predicts hard clinical events (HCE) after percutaneous coronary intervention (PCI) in three-vessel disease patients than the SYNTAX score (SS). CSS offers improved risk stratification for PCI outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Risk Stratification

Background:

  • The SYNTAX score (SS) and Clinical SYNTAX score (CSS) are used for risk stratification after percutaneous coronary intervention (PCI).
  • Predictive determinants for hard clinical events (HCE) following PCI with routine angiographic follow-up require further elucidation.
  • Hard clinical events (HCE) include death, nonfatal myocardial infarction, and stroke.

Purpose of the Study:

  • To compare the accuracy of the Clinical SYNTAX score (CSS) and SYNTAX score (SS) in predicting hard clinical events (HCE) in patients with three-vessel disease (TVD) undergoing PCI.
  • To evaluate the utility of CSS and SS as risk-stratifying tools for long-term outcomes after PCI in TVD patients.

Main Methods:

  • Retrospective analysis of clinical outcomes in 252 patients with three-vessel disease (TVD) who underwent PCI.
  • Assessment of the incidence of hard clinical events (HCE) and repetitive revascularization at 3 years.
  • Comparison of event rates based on high, intermediate, and low SS and CSS categories using log-rank tests.

Main Results:

  • The incidence of HCE at 3 years significantly differed by CSS (High: 20.2%, Intermediate: 1.2%, Low: 6.0%; p<0.001), but not by SS (High: 14.0%, Intermediate: 5.8%, Low: 7.3%; p=0.13).
  • Repetitive revascularization rates at 3 years did not significantly differ among SS or CSS categories.
  • CSS demonstrated superior accuracy in predicting HCE compared to SS in this TVD patient cohort.

Conclusions:

  • The Clinical SYNTAX score (CSS) is a more accurate predictor of hard clinical events (HCE) than the SYNTAX score (SS) in patients with three-vessel disease (TVD) undergoing PCI.
  • CSS provides valuable risk stratification for predicting major adverse cardiovascular events in this population.
  • Further research may refine risk assessment strategies using CSS in interventional cardiology.
Abstract

Keywords:
Clinical SYNTAX scoreHard clinical eventsPercutaneous coronary intervention

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