TY - JOUR
T1 - Quantification and Impact of Untreated Coronary Artery Disease After Percutaneous Coronary Intervention The Residual SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) Score
AU - Genereux, P
AU - Palmerini, T
AU - Caixeta, A
AU - Rosner, G
AU - Green, P
AU - Dressler, O
AU - Xu, K
AU - Parise, H
AU - Mehran, R
AU - Serruys, PWJC (Patrick)
AU - Stone, GW
PY - 2012
Y1 - 2012
N2 - Objectives The purpose of this study was to quantify the extent and complexity of residual coronary stenoses following percutaneous coronary intervention (PCI) and to evaluate its impact on adverse ischemic outcomes. Background Incomplete revascularization (IR) after PCI is common, and most studies have suggested that IR is associated with a worse prognosis compared with complete revascularization (CR). However, formal quantification of the extent and complexity of residual atherosclerosis after PCI has not been performed. Methods The baseline Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score (bSS) from 2,686 angiograms from patients with moderate-and high-risk acute coronary syndrome (ACS) undergoing PCI enrolled in the prospective ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial was determined. The SS after PCI was also assessed, generating the "residual" SS (rSS). Patients with rSS >0 were defined as having IR and were stratified by rSS tertiles, and their outcomes we Results The bSS was 12.8 +/- 6.7, and after PCI the rSS was 5.6 +/- 2.2. Following PCI, 1,084 patients (40.4%) had rSS = 0 (CR), 523 (19.5%) had rSS >0 but <= 2, 578 (21.5%) had rSS >2 but <= 8, and 501 patients (18.7%) had rSS >8. Age, insulin-treated diabetes, hypertension, smoking, elevated biomarkers or ST-segment deviation, and lower ejection fraction were more frequent in patients with IR compared with CR. The 30-day and 1-year rates of ischemic events were significantly higher in the IR g Conclusions The rSS is useful to quantify and risk-stratify the degree and complexity of residual stenosis after PCI. Specifically, rSS >8.0 after PCI in patients with moderate-and high-risk ACS is associated with a poor 30-day and 1-year prognosis. (Comparison of Angiomax Versus Heparin in Acute Coronary Syndromes; NCT00093158) (J Am Coll Cardiol 2012;59:2165-74) (C) 2012 by the American College of Cardiology Foundation
AB - Objectives The purpose of this study was to quantify the extent and complexity of residual coronary stenoses following percutaneous coronary intervention (PCI) and to evaluate its impact on adverse ischemic outcomes. Background Incomplete revascularization (IR) after PCI is common, and most studies have suggested that IR is associated with a worse prognosis compared with complete revascularization (CR). However, formal quantification of the extent and complexity of residual atherosclerosis after PCI has not been performed. Methods The baseline Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score (bSS) from 2,686 angiograms from patients with moderate-and high-risk acute coronary syndrome (ACS) undergoing PCI enrolled in the prospective ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial was determined. The SS after PCI was also assessed, generating the "residual" SS (rSS). Patients with rSS >0 were defined as having IR and were stratified by rSS tertiles, and their outcomes we Results The bSS was 12.8 +/- 6.7, and after PCI the rSS was 5.6 +/- 2.2. Following PCI, 1,084 patients (40.4%) had rSS = 0 (CR), 523 (19.5%) had rSS >0 but <= 2, 578 (21.5%) had rSS >2 but <= 8, and 501 patients (18.7%) had rSS >8. Age, insulin-treated diabetes, hypertension, smoking, elevated biomarkers or ST-segment deviation, and lower ejection fraction were more frequent in patients with IR compared with CR. The 30-day and 1-year rates of ischemic events were significantly higher in the IR g Conclusions The rSS is useful to quantify and risk-stratify the degree and complexity of residual stenosis after PCI. Specifically, rSS >8.0 after PCI in patients with moderate-and high-risk ACS is associated with a poor 30-day and 1-year prognosis. (Comparison of Angiomax Versus Heparin in Acute Coronary Syndromes; NCT00093158) (J Am Coll Cardiol 2012;59:2165-74) (C) 2012 by the American College of Cardiology Foundation
U2 - 10.1016/j.jacc.2012.03.010
DO - 10.1016/j.jacc.2012.03.010
M3 - Article
C2 - 22483327
SN - 0735-1097
VL - 59
SP - 2165
EP - 2174
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 24
ER -
