Potential Utility of the SYNTAX Score 2 in Patients Undergoing Left Main Angioplasty
| Autor: | Miguel Mendes, Henrique Mesquita Gabriel, João Brito, Rui Campante Teles, Manuel Almeida, Francisco Pereira Machado, Luís Raposo, Ricardo C. Rodrigues, Sérgio Madeira, Pedro Gonçalves |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
lcsh:Diseases of the circulatory (Cardiovascular) system Redução de Risco Fatores de Risco Time Factors medicine.medical_treatment Coronary Artery Disease Angioplasty balloon coronary/adverse effects 030204 cardiovascular system & hematology Coronary Angiography Severity of Illness Index Coronary Artery Bypass / adverse effects Coronary artery disease 0302 clinical medicine Risk Factors Reference Values Coronary artery bypass/adverse effects Myocardial Revascularization 030212 general & internal medicine Angioplasty Balloon Coronary Prospective cohort study Doença da Artéria Coronariana / cirurgia Coronary Artery Disease / surgery Middle Aged humanities Treatment Outcome Coronary artery disease/surgery Calibration Original Article Female Cardiology and Cardiovascular Medicine Risk assessment Revascularização Miocárdica medicine.medical_specialty Revascularization Risk Assessment Sensitivity and Specificity Disease-Free Survival Statistics Nonparametric Angioplasty Balloon Coronary / adverse effects 03 medical and health sciences Angioplasty Severity of illness medicine Humans Ponte de Artéria Coronária / efeitos adversos Aged Retrospective Studies business.industry Percutaneous coronary intervention Reproducibility of Results Retrospective cohort study medicine.disease Surgery lcsh:RC666-701 Angioplastia Coronária com Balão / efeitos adversos business |
| Zdroj: | Arquivos Brasileiros de Cardiologia Arquivos Brasileiros de Cardiologia, Vol 106, Iss 4, Pp 270-278 (2016) Arquivos Brasileiros de Cardiologia v.106 n.4 2016 Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
| ISSN: | 1678-4170 0066-782X |
| Popis: | Background: The revascularization strategy of the left main disease is determinant for clinical outcomes.Objective: We sought to 1) validate and compare the performance of the SYNTAX Score 1 and 2 for predicting major cardiovascular events at 4 years in patients who underwent unprotected left main angioplasty and 2) evaluate the long-term outcome according to the SYNTAX score 2--recommended revascularization strategy. Methods: We retrospectively studied 132 patients from a single--centre registry who underwent unprotected left main angioplasty between March 1999 and December 2010. Discrimination and calibration of both models were assessed by ROC curve analysis, calibration curves and the Hosmer--Lemeshow test. Results: Total event rate was 26.5% at 4 years. The AUC for the SYNTAX Score 1 and SYNTAX Score 2 for percutaneous coronary intervention, was 0.61 (95% CI:0.49--0.73) and 0.67 (95% CI:0.57--0.78), respectively. Despite a good overall adjustment for both models, the SYNTAX Score 2 tended to underpredict risk. In the 47 patients (36%) who should have undergone surgery according to the SYNTAX Score 2, event rate was numerically higher (30% vs. 25%; p = 0.54), and for those with a higher difference between the two SYNTAX Score 2 scores (Percutaneous coronary intervention vs. Coronary artery by--pass graft risk estimation greater than 5.7%), event rate was almost double (40% vs. 22%; p = 0.2).Conclusion: The SYNTAX Score 2 may allow a better and individualized risk stratification of patients who need revascularization of an unprotected left main coronary artery. Prospective studies are needed for further validation. |
| Databáze: | OpenAIRE |
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