Abstract 12426: The Incremental Impact of Residual SYNTAX Score on Long-Term Clinical Outcomes in Patients With Multivessel Coronary Artery Disease Treated by Percutaneous Coronary Interventions
Background: incomplete coronary revascularization (ICR) is associated with worse prognosis in patients with severe coronary artery disease (CAD), but there is no consensus as to it’s definition. There is a need to define ‘acceptable’ ICR in order to optimize the allocation of patients with severe CAD to CABG/PCI and improve long-term clinical outcomes.
Methods: We studied 150 consecutive patients with triple vessel/left main (3VD/LM) CAD treated by percutaneous coronary interventions (PCI). Clinical outcomes at 3 years were collected, the SYNTAX score (SS) and residual SYNTAX score (rSS) were calculated. We used various definitions of ‘acceptable’ ICR :no post PCI total occlusion, single vs. mutivessel residual post PCI disease and the rSS at a cutoff determined according to an ROC curve fitted for 3 years major adverse cardiovascular and cerebrovascular adverse events(MACCE), in order to determine which definition is most strongly correlated with long term outcomes.
Results: rSS< 8 , was associated with a significant reductions in 3 year MACCE (19.4 vs. 51.1%, HR=3.62, P=0.014), Death/MI/CVA (13.7 vs. 28.8%, HR=6.01, p=0.030) and repeat revascularization (8.6 vs. 28.9%, HR=3.44, p=0.026) using a Cox proportional hazard ratio model adjusted to all baseline characteristics, whereas single vessel residual disease and absence of total occlusion were not .
Conclusions: ’acceptable’ ICR as determined by rSS, carries better long-term prognosis in terms of clinical outcomes vs. more extensive residual coronary disease in patients with 3VD/LMCAD treated by PCI. The rSS may improve the allocation of coronary patients to the optimal mode of revascularization.
Author Disclosures: G. Witberg: None. I. Lavi: None. A. Assali: None. H. Vaknin-Assa: None. E. Lev: None. R. Kornowski: None.
- © 2014 by American Heart Association, Inc.