SYNTAX Score and 1-Year Outcomes in the OPTIVUS-Complex PCI Study Multivessel Cohort

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Optimal revascularization strategy for multivessel disease with intermediate SYNTAX score (SS) remains unclear.
• Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) is a key technique for complex coronary artery disease.

Purpose of the Study:

• To evaluate clinical outcomes of IVUS-guided PCI in patients with multivessel disease stratified by SS.
• To compare major adverse cardiac and cerebrovascular events (MACCE) across different SS groups.

Main Methods:

• Substudy of the OPTIVUS-Complex PCI study Multivessel Cohort.
• 1,005 patients categorized into low (≤22), intermediate (23-32), and high (≥33) SS groups.
• Primary endpoint: 1-year MACCE (composite of death, myocardial infarction, stroke, or revascularization).

Main Results:

• High SS group had significantly higher 1-year MACCE (25.0%) compared to intermediate (10.9%) and low SS (9.5%) groups (p=0.003).
• Coronary revascularization was the main driver of increased MACCE in high SS patients.
• Multivariable analysis confirmed significantly higher MACCE risk for high SS vs. low SS (HR 3.19), but not for intermediate vs. low SS (HR 1.20).

Conclusions:

• IVUS-guided multivessel PCI resulted in similar 1-year MACCE risk for intermediate SS patients as for low SS patients.
• Patients with high SS exhibited a higher 1-year MACCE risk following IVUS-guided multivessel PCI compared to low SS patients.