TY - JOUR
T1 - Value of the SYNTAX Score for Risk Assessment in the All-Comers Population of the Randomized Multicenter LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) Trial
AU - Wykrzykowska, Joanna
AU - Garg, Scot
AU - Girasis, Chrysafios
AU - de Vries, T (Ton)
AU - Morel, Marie-Angele
AU - Es, Gerrit-anne
AU - Buszman, P
AU - Linke, A
AU - Ischinger, T
AU - Klauss, V
AU - Corti, R
AU - Eberli, F
AU - Wijns, W (William)
AU - Morice, MC
AU - di Mario, C (Carlo)
AU - van Geuns, Robert Jan
AU - Juni, P
AU - Windecker, S
AU - Serruys, PWJC (Patrick)
PY - 2010
Y1 - 2010
N2 - Objectives We aimed to assess the predictive value of the SYNTAX score (SXscore) for major adverse cardiac events in the all-comers population of the LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) trial. Background The SXscore has been shown to be an effective predictor of clinical outcomes in patients with multivessel disease undergoing percutaneous coronary intervention. Methods The SXscore was prospectively collected in 1,397 of the 1,707 patients enrolled in the LEADERS trial (patients after surgical revascularization were excluded). Post hoc analysis was performed by stratifying clinical outcomes at 1-year follow-up, according to 1 of 3 SXscore tertiles. Results The 1,397 patients were divided into tertiles based on the SXscore in the following fashion: SXscore <= 8 (SXlow) (n = 464), SXscore > 8 and <= 16 (SXmid) (n = 472), and SXscore <= 16 (SXhigh) (n = 461). At 1-year follow-up, there was a significantly lower number of patients with major cardiac event-free survival in the highest tertile of SXscore (SXlow = 92.2%, SXmid = 91.1%, and SXhigh = 84.6%; p < 0.001). Death occurred in 1.5% of SXlow patients, 2.1% of SXmid patients, and 5.6% of SXhigh patients (hazard ratio [HR]: 1.97, 95% confidence interval [CI]: 1.29 to 3.01; p = 0.002). The myocardial infarction rate tended to be higher in the SXhigh group. Target vessel revascularization was 11.3% in the SXhigh group compared with 6.3% and 7.8% in the SXlow and SXmid groups, respectively (HR: 1.38, 95% CI: 1.1 to 1.75; p = 0.006). Composite of cardiac death, myocardial infarction, and clinically indicated target vessel revascularization was 7.8%, 8.9%, and 15.4% in the SXlow, SXmid, and SXhigh groups, respectively (HR: 1.47, 95% CI: 1.19 to 1.81; p < 0.001). Conclusions The SXscore, when applied to an all-comers patient population treated with drug-eluting stents, may allow prospective risk stratification of patients undergoing percutaneous coronary intervention. (LEADERS Trial Limus Eluted From A Durable Versus ERodable Stent Coating; NCT00389220). (J Am Coll Cardiol 2010; 56: 272-7) (c) 2010 by the American College of Cardiology Foundation
AB - Objectives We aimed to assess the predictive value of the SYNTAX score (SXscore) for major adverse cardiac events in the all-comers population of the LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) trial. Background The SXscore has been shown to be an effective predictor of clinical outcomes in patients with multivessel disease undergoing percutaneous coronary intervention. Methods The SXscore was prospectively collected in 1,397 of the 1,707 patients enrolled in the LEADERS trial (patients after surgical revascularization were excluded). Post hoc analysis was performed by stratifying clinical outcomes at 1-year follow-up, according to 1 of 3 SXscore tertiles. Results The 1,397 patients were divided into tertiles based on the SXscore in the following fashion: SXscore <= 8 (SXlow) (n = 464), SXscore > 8 and <= 16 (SXmid) (n = 472), and SXscore <= 16 (SXhigh) (n = 461). At 1-year follow-up, there was a significantly lower number of patients with major cardiac event-free survival in the highest tertile of SXscore (SXlow = 92.2%, SXmid = 91.1%, and SXhigh = 84.6%; p < 0.001). Death occurred in 1.5% of SXlow patients, 2.1% of SXmid patients, and 5.6% of SXhigh patients (hazard ratio [HR]: 1.97, 95% confidence interval [CI]: 1.29 to 3.01; p = 0.002). The myocardial infarction rate tended to be higher in the SXhigh group. Target vessel revascularization was 11.3% in the SXhigh group compared with 6.3% and 7.8% in the SXlow and SXmid groups, respectively (HR: 1.38, 95% CI: 1.1 to 1.75; p = 0.006). Composite of cardiac death, myocardial infarction, and clinically indicated target vessel revascularization was 7.8%, 8.9%, and 15.4% in the SXlow, SXmid, and SXhigh groups, respectively (HR: 1.47, 95% CI: 1.19 to 1.81; p < 0.001). Conclusions The SXscore, when applied to an all-comers patient population treated with drug-eluting stents, may allow prospective risk stratification of patients undergoing percutaneous coronary intervention. (LEADERS Trial Limus Eluted From A Durable Versus ERodable Stent Coating; NCT00389220). (J Am Coll Cardiol 2010; 56: 272-7) (c) 2010 by the American College of Cardiology Foundation
U2 - 10.1016/j.jacc.2010.03.044
DO - 10.1016/j.jacc.2010.03.044
M3 - Article
SN - 0735-1097
VL - 56
SP - 272
EP - 277
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -