Abstract 16388: Residual SYNTAX Score and Survival Following Coronary Artery Bypass Grafting: Analysis of 1608 Patients
Introduction: We and others have previously shown that SYNTAX score predicts outcome in patients undergoing coronary artery bypass grafting (CABG). More recently, the residual SYNTAX score (rSS) has emerged as a reliable tool to quantify the extent and complexity of untreated coronary lesions after percutaneous coronary intervention (PCI). Indeed, rSS is an independent predictor of morbidity and mortality following PCI. Whether rSS may help to stratify mortality risk after CABG remains largely unknown.
Hypothesis: The present study was designed to investigate the predictive value of rSS on mortality risk in a prospective cohort of patients undergoing surgical revascularization.
Methods: Average baseline SYNTAX score calculated on 1608 patients (mean age 68±6 years, F:M 213:1395) undergoing isolated first-time CABG was 26.6 ± 9.4. The rSS measured after CABG was 3.2 ± 1.8 (p<0.001 vs baseline). Complete revascularization was assumed as rSS=0. Based on rSS tertiles, the study population was stratified in low rSS (0<rSS<2), intermediate rSS (2<rSS<8) and high rSS (rSS>8).
Results: Following CABG, 1157/1608 (71.9%) patients had rSS=0, whereas 209/1608 (12.9%) had low rSS, 176/1608 (10.9%) had intermediate rSS and 66/1608 (4.1%) had high rSS. At Kaplan-Meier analysis of survival subjects in the highest rSS tertile (rSS>8) showed significant worse survival as compared to patients with rSS=0, 0<rSS<2 and 2<rSS<8 (χ2 77.1, p<0.0001). Cox proportional-hazards regression analysis adjusted for age, gender, diabetes, preoperative LV and renal function showed rSS to be an independent predictor of 1-year survival (b 0.48, p<0.0001).
Conclusions: These unanticipated findings suggest that residual SYNTAX score may stratify mortality risk in patients undergoing isolated first-time CABG. Our study may set the stage for further investigation addressing this important clinical question.
Author Disclosures: G. Melina: None. E. Angeloni: Research Grant; Modest; PhD Program from Sapienza University of Rome. S. Refice: None. C.V. Benegiamo: None. A. Lechiancole: None. A. Roscitano: None. R. Bianchini: None. P. Spitaleri: None. F. Capuano: None. C. Comito: None. M. Goracci: None. S. Rosato: None. F. Seccareccia: None. F. Monti: None. R. Serdoz: None. F. Colivicchi: None. F. Paneni: None. R. Sinatra: None.
- © 2014 by American Heart Association, Inc.