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Impact of the SYNTAX score on risk stratification after percutaneous coronary intervention in non-selected patients

BACKGROUND: The SYNTAX score was developed as an angiographic tool to grade the complexity of coronary artery disease in patients with three-vessel and/or left main disease. We evaluated its role in predicting clinical outcomes after percutaneous coronary intervention (PCI) in non-selected patients, treated in the daily clinical practice of a reference center. METHODS: Analysis of patients undergoing PCI from March to September 2009 and followed-up for up to 12 months. Patients were divided in tertiles according to the SYNTAX score. The primary endpoint included major adverse cardiac events (MACE) - death, non-fatal acute myocardial infarction and target-vessel revascularization. The ability of the SYNTAX score in predicting MACE was assessed by the ROC (Receiver Operator Characteristic) curve. RESULTS: Two hundred and thirty-four patients with a mean SYNTAX score of 11.6 ± 6.2 points were included. Tertile I had a SYNTAX score < 9 (average 5.9); tertile II, > 9 and < 13 (average 10.8); and tertile III, > 13 (average 18.3). In the clinical follow-up of 7.2 ± 4.9 months, the incidence of MACE was greater in tertile III when compared to tertiles I and II (2.5% vs. 6.4% vs. 14.1%; P = 0.0075). The ROC curve showed an area under the curve of 0.667 (P = 0.012) indicating a moderate ability to anticipate the occurrence of MACE in this population. CONCLUSIONS: The SYNTAX score proved to be seful in predicting the occurrence of MACE after PCI in real world patients.

Coronary disease; Angioplasty; Stents; Drug-eluting stents; Prognosis


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