Prognostic value of anatomical SYNTAX score in patients with acute ST elevation myocardial infarction undergoing percutaneous coronary intervention for unprotected left main coronary artery
| Autor: | Ahmet Karakurt, Cennet Yildiz, Abdulmelik Yildiz, Bayram Bağırtan |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
business.industry Mortality rate medicine.medical_treatment Stent Percutaneous coronary intervention 030204 cardiovascular system & hematology Revascularization Culprit SYNTAX score 03 medical and health sciences ST elevation myocardial infarction 0302 clinical medicine LMCA disease Internal medicine Conventional PCI medicine Cardiology cardiovascular diseases 030212 general & internal medicine Radiology Cardiology and Cardiovascular Medicine business Mace Survival analysis |
| Zdroj: | International Journal of the Cardiovascular Academy. 2:98-102 |
| ISSN: | 2405-8181 |
| Popis: | Objective Acute ST-elevation myocardial infarcion (STEMI) due to left main coronary artery (LMCA) disease has high mortality rate. Advancements in stent technology have shown promising results in patients with unprotected left main coronary artery (ULMCA) disease. SYNTAX score (SxS) is recommended to determine appropriate patients for revavascularization with PCI. However, predictive value of SxS in patients with STEMI who underwent primary PCI due to ULMCA disease has not fully been evaluated. Methods and Results 53 patients with STEMI who underwent emergent PCI to a culprit LMCA lesion were enrolled in this study. Patients were divided into three groups on the basis of their SxS; low (≤ 22; n = 14), intermediate ( 23–32; n = 14) and high (≥ 33; n = 25). During a follow-up of 3 years, SxS exhibited 62.2% sensitivity and 62.5% specificity for predictiing development of MACE at a cut off value 28.25 (AUC: 0.731, P = 0.008), 70% sensitivity and 66.7% specificity for predicting mortality at a cut off value 31.25 (AUC:0.675, P = 0.034). At 3-year follow-up, the incidences of mortality, major adverse cardiac events (MACE) and targel vessel revascularization (TVR) were significantly higher in patients with high SxS group than in the intermediate and low SxS groups. In Kaplan–Meier survival analysis, survival rates of the low, intermediate, and high SxS groups were 91.7%, 78.6%, and 64.7%, respectively. Conclusions Patients with acute STEMI who were treated with emergency PCI to a culprit ULMCA lesion, SxS is an important aid to deciding the appropriate revascularization strategy, can be derived quickly and repeatable. |
| Databáze: | OpenAIRE |
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