Abstract 17592: SYNTAX Score Predicts Major Adverse Cardiac Events Among Patients who Underwent Coronary Angiography for Investigation of Chronic Coronary Artery Disease
Background: The classification of coronary lesions by several scores helps to establish the prognosis of chronic coronary artery disease (CAD), but they are not widely used in clinical practice. The SXscore can predict MACE in patients treated with percutaneous coronary intervention (PCI) in multiple clinical scenarios. Its ability to predict outcomes in patients with CAD submitted to diagnostic angiography has not been tested to date. Objective: To evaluate the prognostic performance of the SYNTAX score (SXscore) to predict major adverse cardiovascular events (MACE) in a cohort of patients undergoing elective coronary angiography.
Methods: The SXscore was calculated prospectively in 895 patients enrolled in a cohort of patients with suspected CAD submitted to coronary angiography at Hospital de Clinicas de Porto Alegre, Brazil. The SXscore was stratified in the following categories: SXscoreZERO: 0 (n=495), SXscoreLOW:>0 and <23 (n=346) and SXscoreHIGH: ≥23 (n=54).Primary outcome was MACE, a composite of cardiac death, myocardial infarction (MI), and late revascularization. Secondary endpoints were the components of MACE and death from any cause.
Results: 895 patients with SXscore were included in the cohort and followed on average by 1.8 ± 1.4 years. There were 495 patients with a score of 0 (55.4%) and 400 (44.6%) with positive scores, ranging from 1 to 43, with a mean of 12.6 (95% confidence interval, CI 11.7-13.4). The primary outcome occurred in 2.2%, 15.3% and 20.4% of the SXscoreZERO, SXscoreLOW, and SXscoreHIGH, respectively (P<0.001). Patients in the SXscoreLOW and SXscoreHIGH categories had an adjusted hazard ratio (HR) for MACE of 7.0 (95% CI 3.6-13.4) and 12.3 (95% CI 5.2-29.0) compared to the SXscoreZERO category, respectively. For all-cause death, HR for SXscoreLOW and SXscoreHIGH groups were 0.8 (95% CI 0.4-1.7) and 4.1 (95% CI 1.8-9.3), respectively. Cardiac death, MI and late revascularization were all significantly associated with the SXscoreHIGH category (P<0.001).
Conclusions: SXscore independently predicts MACE in patients with suspected CAD submitted to elective coronary angiography. The routine use of this tool may help to identify patients with worse prognosis in this scenario.
- © 2012 by American Heart Association, Inc.