Comparison of SYNTAX score, clinical SYNTAX score and residual SYNTAX score as predictors of one year clinical outcomes in octogenarian patients with multivessel coronary artery disease undergoing percutaneous coronary intervention

doi:10.3760/cma.j.issn.1673-4777.2014.02.005

Abstract：Objective To investigate the ability of SYNTAX score (SS),clinical SYNTAX score (CSS) and residual SYNTAX score (RSS) regarding predicting one year major adverse cardiac and cerebrovascular events (MACCE) rates in octogenarian patients with multivessel coronary artery disease undergoing percutaneous coronary intervention(PCI).Methods The data of over 80 years old patients with multivessellesion undergoing PCI from January 2010 to January 2012 were retrospectively analyzed.The SS and RSS were calculated before and after PCI.The CSS was calculated using age,left ventricular ejection fraction (LVEF),creatinine clearance and SS.Tertiles for SS,CSS and RSS were defined as SSlow ≤ 13,13 ＜ SSmid ≤ 20 and SShigh ＞ 20,CSSlow 31,31 ＜ CSSmid ≤ 57and CSShigh ＞ 57,RSSlow ≤ 2,2 ＜ RSSmid ≤ 9 and RSShigh ＞ 9,respectively.Major adverse cardiovascular events (MACCE) rates (all-cause mortality,nonfatal myocardial infarction,target vessel revascularization and stroke)were followed-up at one year.Results Among 199 cases,13 cases were lost to follow-up,SSlow group had 62 cases,SSmid group had 63 cases,SShigh group had 61 cases; RSSIow group had 65 cases,RSSmid group had 61 cases,RSShigh group had 60 cases; CSSIow group had 64 cases,CSSmid group had 61 cases,CSShigh group had 61 cases.MACCE rate was 12.9％ (8 cases),23.8％ (15 cases) and 41.0％ (25 cases) in SSlow,SSmid and SShigh group,respectively.MACCE rate was 17.2％ (11 cases),21.3％ (13 cases) and 39.3％ (24 cases) in CSSlow,CSSmid and CSShigh group,respectively.MACCE rate was 20.0％ (13 cases),29.5％ (18 cases) and 28.3％ (17 cases)in RSSlow,RSSmid and RSShigh group,respectively.Patients in the high tertiles of SS and CSS experienced significant elevated MACCE compared with low and middle tertiles (all P ＜ 0.05).By multivariable Cox-regression analysis,SS(HR:1.28,95％CI:1.08-1.56,P=0.01) and CSS (HR:1.07,95％CI:1.04-1.10,P =0.01)were independent predictors of 1-year MACCE.Receiver-operator characteristic (ROC) curve analysis showed both SS[area under curve (AUC) =0.710 (95％ CI:0.629-0.791),P =0.001] and CSS [AUC =0.687,95％ CI:0.597-0.777,P =0.001] had predictive value of MACCE in octogenarian patients with multivessel coronary artery disease undergoing PCI.Conclusion SS and CSS are able to stratify risks for one year MACCE in octogenarian patients with multvessel coronary artery disease undergoing PCI.While considering the three important clinical factors,and CSS integral prediction effect is not better than that of the SYNTAX score.