Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial
Randomized controlled trial published in Journal of the American College of Cardiology (2011)
Abstract
OBJECTIVES: We sought to investigate the predictive value of the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) score (SS) for risk assessment of 1-year clinical outcomes in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention (PCI). BACKGROUND: In the SYNTAX trial, the SS was effective in risk-stratifying patients with left main and triple-vessel coronary disease, the majority of whom had stable ischemic heart disease. METHODS: The SS was determined in 2,627 patients with non-ST-segment elevation acute coronary syndromes undergoing PCI in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial. Patients were stratified according to tertiles of the SS: <7 (n = 854), ≥ 7 and <13 (n = 825), and ≥ 13 (n = 948). RESULTS: Among patients in the first, second, and third SS tertiles, the 1-year rates of mortality were 1.5%, 1.6%, and 4.0%, respectively (p = 0.0005); the cardiac mortality rates were 0.2%, 0.9%, and 2.7%, respectively (p < 0.0001); the myocardial infarction (MI) rates were 6.3%, 8.3%, and 12.9%, respectively (p < 0.0001); and the target vessel revascularization (TVR) rates were 7.4%, 7.0%, and 9.8%, respectively (p = 0.02). By multivariable analysis, the SS was an independent predictor of 1-year death (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.01 to 1.07; p = 0.005), cardiac death (HR: 1.06, 95% CI: 1.03 to 1.09; p = 0.0002), MI (HR: 1.03, 95% CI: 1.02 to 1.05; p < 0.0001), and TVR (HR: 1.03, 95% CI: 1.02 to 1.05; p < 0.0001). The SS affected death, cardiac death, and MI both within the first 30 days after PCI and between 30 days and 1 year, whereas it affected TVR primarily within the first 30 days. The predictive value of an increased SS was consistent among multiple pre-specified subgroups. CONCLUSIONS: In patients with non-ST-segment elevation acute coronary syndromes undergoing PCI, the SS is an independent predictor of the 1-year rates of death, cardiac death, MI, and TVR. (Comparison of Angiomax Versus Heparin in Acute Coronary Syndromes [ACS]; NCT00093158).
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
We sought to investigate the predictive value of the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) score (SS) for risk assessment of 1-year clinical outcomes in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention (PCI).
Почему это важно для гирудотерапии
В этом анализе клинического исследования оценивалась прогностическая ценность шкалы SYNTAX для предсказания клинических исходов через 1 год у пациентов с острыми коронарными синдромами без подъема сегмента ST, подвергающихся чрескожному коронарному вмешательству. В исследовании было обнаружено, что шкала SYNTAX является независимым предиктором смерти, сердечной смерти, инфаркта миокарда и реваскуляризации целевого сосуда. Исследование полностью сосредоточено на стратификации сердечно-сосудистого риска и интервенционной кардиологии. Таким образом, оно не имеет прямого отношения к Американскому обществу гирудотерапии, лечению пиявками или секрету пиявок. Хотя более широкое исследование включает использование антикоагулянтов, в данной конкретной аннотации не приводятся данные о гирудине, пиявках или каких-либо смежных терапевтических применениях.
Цитирование
Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial
Palmerini T et al. · Journal of the American College of Cardiology, 2011
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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