Impact of the SYNTAX Score in the Prognosis of Patients with Multivessel Disease Treated by Percutaneous Coronary Intervention

Background:

The SYNTAX score stratifies the angiographic complexity of coronary artery disease and establishes the prognosis of patients with triple vessel and/or left main coronary artery disease, being an important tool to decide the best revascularization strategy. We assessed the impact of the SYNTAX score in the prognosis of a daily practice population with multivessel coronary artery disease treated by percutaneous coronary intervention with drug-eluting stents.

Methods:

We identified in the SAFIRA Registry elective patients with multivessel coronary artery disease treated with drug-eluting stents. Patients were grouped in SYNTAX score ≤ 8; SYNTAX score > 8 and ≤ 16, and SYNTAX score > 16, and clinical outcomes in terms of major adverse cardiac events were stratified according to the SYNTAX score groups.

Resultados:

Between 2009 and 2014, we identified 244 patients that met the study inclusion criteria. Patients were distributed in those with SYNTAX score ≤ 8 (n = 61; 25%), > 8 and ≤ 16 (n = 116; 47.5%), and > 16 (n = 67; 27.5%). Mean age was 64.6 ± 11.5 years and 73% were male. The SYNTAX score ranged between 1 and 39, with an average of 13.4 ± 6.8. In the follow-up period of 3.6 ± 2.1 years, there were higher rates of major adverse cardiac events in group > 16 (4.9% vs. 6.9% vs. 11.9%; p < 0.01) due to a higher incidence of target vessel revascularization (1.6% vs. 2.6% vs. 7.5%; p = 0.08). Four cases of definitive or probable stent thrombosis were detected (zero vs. 1.7% vs. 3.0%; p = 0.41).

Conclusão:

The SYNTAX score is able to stratify the risk of a daily practice population with coronary multivessel disease treated by percutaneous coronary intervention with drug-eluting stents.

Coronary artery disease; Percutaneous coronary intervention; Drug-eluting; Prognosis