Abstract 15743: The Clinical Syntax Score Is A Predictor Of 5-year Clinical Outcomes After Sirolimus-eluting Stents Implantation Amongst All-comers Population
Purpose: The SYNTAX score is able to stratify risk amongst a real world population treated with drug-eluting stents. However, the SYNTAX score is based on only lesion-based scoring system. The Clinical SYNTAX Score (CSS),which has been previously published, is achieved by combining the SYNTAX score with a simple clinical risk score incorporating age, ejection fraction and creatinine clearance. We sought to assess its ability to stratify long-term outcomes in all patients who underwent percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES).
Methods: Between August 2004 and March 2005, consecutive 249 patients underwent PCI with SES at our institution. Clinical follow-up was retrospectively evaluated at 5 years. The CSS was available for 206 (82.7%) patients, except 43 patients with prior coronary artery bypass grafts surgery.
Results: Five-year clinical follow-up was available in 201 (97.6%) patients. The CSS ranged from 1 to 322, with a mean±SD of 35.3±49.9 and a median of 17.5. We divided them according to their CSS into tertiles defined as: CSS-LOW <= 9.5 (n=67), 9.5 < CSS-MID <= 28 (n=67), CSS-HIGH > 28 (n=67). At 5-year follow-up, CSS-HIGH was associated with a significantly high rate of death and non-fatal myocardial infarction (MI) (CSS-LOW = 13.4%, CSS-MID = 19.4%, and CSS-HIGH = 46.3%; log-rank p < 0.001) and major adverse cardiovascular events (MACE) (CSS-LOW = 29.8%, CSS-MID = 35.8%, and CSS-HIGH = 61.2%; log-rank p = 0.004). After multivariate analyses, independent predictors for death and non-fatal MI were the CCS (hazard ratio [HR]: 1.89, 95% confidence interval [CI]: 1.27 to 2.81; p = 0.002) and hemodialysis (HR: 2.11, 95% CI: 1.07 to 4.17; p = 0.032) and for MACE were hemodialysis (HR: 2.53, 95% CI: 1.40 to 4.56; p = 0.002) and the CCS (HR: 1.4, 95% CI: 1.04 to 1.89; p = 0.028).
Conclusions: The CSS is a useful score to predict the 5 years clinical outcomes in patients treated with SES in the real world setting.
- © 2011 by American Heart Association, Inc.