Dataset Information

SYNTAX score II predicts long-term mortality in patients with one- or two-vessel disease.

ABSTRACT:

Objective

SYNTAX score II (SSII) is a long-term mortality prediction model to guide the decision making of the heart-team between coronary artery bypass grafting or percutaneous coronary intervention (PCI) in patients with left main or three-vessel coronary artery disease. This study aims to investigate the long-term predictive value of SSII for all-cause mortality in patients with one- or two-vessel disease undergoing PCI.

Methods

A total of 628 patients (76% men, mean age: 61±10 years) undergoing PCI due to stable angina pectoris (43%) or acute coronary syndrome (57%), included between January 2008 and June 2013, were eligible for the current study. SSII was calculated using the original SYNTAX score website (www.syntaxscore.com). Cox regression analysis was used to assess the association between continuous SSII and long-term all-cause mortality. The area under the receiver-operating characteristic curve was used to assess the performance of SSII.

Results

SSII ranged from 6.6 to 58.2 (median: 20.4, interquartile range: 16.1-26.8). In multivariable analysis, SSII proved to be an independent significant predictor for 4.5-year mortality (hazard ratio per point increase: 1.10; 95% confidence interval: 1.07-1.13; p<0.001). In terms of discrimination, SSII had a concordance index of 0.77.

Conclusion

In addition to its established value in patients with left main and three-vessel disease, SSII may also predict long-term mortality in PCI-treated patients with one- or two-vessel disease.

SUBMITTER: Vroegindewey MM

PROVIDER: S-EPMC6028142 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

SYNTAX score II predicts long-term mortality in patients with one- or two-vessel disease.

Vroegindewey Maxime M MM Schuurman Anne-Sophie AS Oemrawsingh Rohit M RM van Geuns Robert-Jan RJ Kardys Isabella I Ligthart Jurgen J Daemen Joost J Boersma Eric E Serruys Patrick W PW Akkerhuis K Martijn KM

PloS one 20180702 7

<h4>Objective</h4>SYNTAX score II (SSII) is a long-term mortality prediction model to guide the decision making of the heart-team between coronary artery bypass grafting or percutaneous coronary intervention (PCI) in patients with left main or three-vessel coronary artery disease. This study aims to investigate the long-term predictive value of SSII for all-cause mortality in patients with one- or two-vessel disease undergoing PCI.<h4>Methods</h4>A total of 628 patients (76% men, mean age: 61±10 ...[more]

PMID: 29965993

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Project description:BackgroundRadiographic end points commonly are included in therapeutic trials for systemic sclerosis (SSc)-interstitial lung disease (ILD); however, the relationship between these outcomes and long-term mortality is unclear.Research questionDo short-term changes in radiographic measures of ILD predict long-term survival in patients with SSc?Study design and methodsThe Scleroderma Lung Study (SLS) I and II evaluated the safety and efficacy of cyclophosphamide (in SLS I and II) and mycophenolate mofetil (in SLS II) for the treatment of SSc-ILD. Changes in the extent of ILD over time were assessed on high-resolution CT scans of the chest by quantitative image analysis, an approach that applies a computer-based algorithm to assess changes in the radiographic extent of ILD objectively. Participants subsequently were followed for up to 12 years (SLS I) and 8 years (SLS II). Cox proportional hazards models determined whether the change in the quantitative radiographic extent of ILD predicted survival, adjusting for other known predictors of survival.ResultsAmong SLS I and II participants, 82 and 90 had follow-up imaging scans, respectively, and were included in the analysis. Participants in both trials who showed an increase in the total quantitative radiographic extent of ILD scores of ≥ 2% at 12 months (SLS I) or 24 months (SLS II) experienced significantly worse long-term survival than those with change scores of < 2% (P ≤ .01, log-rank test). In the multivariate Cox models, radiographic progression remained associated with worse long-term survival in SLS I (P = .089) and SLS II (P = .014).InterpretationData from two independent clinical trial cohorts with extensive long-term follow-up demonstrated that radiographic progression of ILD over 12 to 24 months, in both treatment and placebo arms, can predict increased risk for long-term mortality in patients with SSc. These findings suggest that radiographic end points may serve as surrogates for mortality in SSc-ILD.

Dataset Information

SYNTAX score II predicts long-term mortality in patients with one- or two-vessel disease.

Objective

Methods

Results

Conclusion

Publications

SYNTAX score II predicts long-term mortality in patients with one- or two-vessel disease.

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