Abstract 16159: Impact of the SYNTAX Score on Revascularization Outcomes for Patients with Multi-Vessel Disease
Background: Questions remain regarding the impact of the SYNTAX score on the relative benefit of coronary artery bypass grafting (CABG) vs percutaneous coronary intervention (PCI) among patients with multi-vessel disease (MVD) without left main (LM) disease in a real-world population.
Methods: In this blinded, retrospective study, SYNTAX scores were calculated in 1,554 patients from database registries including the American College of Cardiology Foundation (ACCF) and the Society of Thoracic Surgeons (STS) who underwent PCI or CABG for either two or three vessel coronary artery disease (CAD) in the absence of LM disease from 2003-2007. Angiographers were blinded to the procedure when determining SYNTAX scores. Mortality up to 4 years was analyzed and was adjusted for the clinical risk and SYNTAX score.
Results: As shown in the figure, CABG was associated with improved survival even in models that adjusted for the clinical risk and SYNTAX score. Four-year mortality, unadjusted for clinical risk and SYNTAX score was 18.53% and 14.97% for PCI and CABG, and when adjusted for clinical risk and SYNTAX score was 17.58% and 15.15% for PCI and CABG, respectively.
Conclusion: In this retrospective observational study, patients with 2 or 3 vessel disease (excluding LM disease), who underwent CABG had a significant long-term survival advantage when compared to patients who underwent PCI even after adjustments were made for the clinical risk and SYNTAX score.
- Aortocoronary bypass
- Comparative effectiveness
- Drug eluting stents
- Health policy
- Interventional cardiology
- © 2012 by American Heart Association, Inc.