The anatomical synergy between percutaneous coronary intervention (PCI) with taxus and cardiac surgery (SYNTAX) score (SS) is advocated in both European and American revascularization guidelines [1,2] as an important tool that can help clinicians to establish the optimal revascularization approach in patients with complex coronary artery disease (CAD). The model has also been proposed as a predictor of clinical outcome following PCI [3]. However, it is well recognized that both anatomical and clinical variables are required to appropriately stratify the risk of patients undergoing PCI. Therefore, recent scores have been developed with the aim of integrating anatomical features with relevant clinical variables, to overcome the most obvious pitfalls of a system score only based on coronary angiograms [4,5]. Recently, seven clinical parameters [age, creatinine clearance, left ventricular ejection fraction (LVEF), presence of unprotected left main (ULM), peripheral vascular disease, female sex, and chronic obstructive pulmonary disease] have been added to SS to obtain SYNTAX score II (SS II) [4]. This new score is able to predict a statistically significant difference in long-term outcomes between patients undergoing coronary artery bypass graft (CABG) and those undergoing PCI [5,6]. However, SS II has been only validated in randomized trials, not in a real-world study; thus, excluding complex patients such as those with three-vessel disease and/or ULM involvement, particularly in the setting of acute coronary syndromes (ACS). The aim of the current study was to evaluate the usefulness of SS II in a real-world population with severe CAD and ACS undergoing PCI.

Usefulness of SYNTAX score II in complex percutaneous coronary interventions in the setting of acute coronary syndrome

GALASSI, ALFREDO
2016-01-01

Abstract

The anatomical synergy between percutaneous coronary intervention (PCI) with taxus and cardiac surgery (SYNTAX) score (SS) is advocated in both European and American revascularization guidelines [1,2] as an important tool that can help clinicians to establish the optimal revascularization approach in patients with complex coronary artery disease (CAD). The model has also been proposed as a predictor of clinical outcome following PCI [3]. However, it is well recognized that both anatomical and clinical variables are required to appropriately stratify the risk of patients undergoing PCI. Therefore, recent scores have been developed with the aim of integrating anatomical features with relevant clinical variables, to overcome the most obvious pitfalls of a system score only based on coronary angiograms [4,5]. Recently, seven clinical parameters [age, creatinine clearance, left ventricular ejection fraction (LVEF), presence of unprotected left main (ULM), peripheral vascular disease, female sex, and chronic obstructive pulmonary disease] have been added to SS to obtain SYNTAX score II (SS II) [4]. This new score is able to predict a statistically significant difference in long-term outcomes between patients undergoing coronary artery bypass graft (CABG) and those undergoing PCI [5,6]. However, SS II has been only validated in randomized trials, not in a real-world study; thus, excluding complex patients such as those with three-vessel disease and/or ULM involvement, particularly in the setting of acute coronary syndromes (ACS). The aim of the current study was to evaluate the usefulness of SS II in a real-world population with severe CAD and ACS undergoing PCI.
2016
CTO; PCI
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/19492
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