Dataset Information

Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial.

ABSTRACT:

Background

Creatinine clearance (CrCl) is an independent determinant of mortality in predictive models of revascularisation outcomes for complex coronary artery disease.

Aims

This study aimed to investigate the impact of preprocedural biological markers on 10-year mortality following coronary revascularisation.

Methods

The SYNTAX Extended Survival (SYNTAXES) study evaluated the 10-year vital status follow-up of 1,800 patients with de novo three-vessel (3VD) and/or left main coronary artery disease (LMCAD) randomised to include percutaneous or surgical coronary revascularisation. The associations between mortality and preprocedural C-reactive protein (CRP), haemoglobin, HbA1c, CrCl, fasting triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were analysed.

Results

Out of 1,800 patients, 460 patients died before the 10-year follow-up. CRP, HbA1c and CrCl with threshold values of ≥2 mg/L, ≥6% (42 mmol/mol) and <60 ml/min, respectively, were associated with 10-year all-cause death (adjusted hazard ratio [95% confidence interval]: 1.35 [1.01-1.82], 1.51 [1.16-1.95], and 1.46 [1.07-2.00], respectively). There was no significant interaction between the biological markers on all-cause mortality and the type of revascularisation. Preprocedural lipid markers were not significantly associated with 10-year all-cause death, but the non-use of statins was a determinant factor of worse prognosis (adjusted hazard ratio [95% confidence interval]: 1.68 [1.26-2.25]).

Conclusions

Preprocedural biomarkers, such as CRP and HbA1c, are associated with long-term mortality post revascularisation, regardless of the revascularisation technique. Conventional lipidic biomarkers associated with high-risk of cardiovascular events seem to be effectively mitigated by the long-term use of statins, whereas the non-use of statins was a factor of a worse prognosis, emphasising the importance of pharmacological treatment.

Trial registration

SYNTAXES ClinicalTrials.gov: NCT03417050. SYNTAX ClinicalTrials.gov: NCT00114972.

SUBMITTER: Hara H

PROVIDER: S-EPMC9896405 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial.

Hara Hironori H Kawashima Hideyuki H Ono Masafumi M Takahashi Kuniaki K Mack Michael J MJ Holmes David R DR Morice Marie-Claude MC Davierwala Piroze M PM Mohr Friedrich W FW Thuijs Daniel J F M DJFM Kappetein Arie Pieter AP O'Leary Neil N van Klaveren David D Onuma Yoshinobu Y Serruys Patrick W PW

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 20220401 18

<h4>Background</h4>Creatinine clearance (CrCl) is an independent determinant of mortality in predictive models of revascularisation outcomes for complex coronary artery disease.<h4>Aims</h4>This study aimed to investigate the impact of preprocedural biological markers on 10-year mortality following coronary revascularisation.<h4>Methods</h4>The SYNTAX Extended Survival (SYNTAXES) study evaluated the 10-year vital status follow-up of 1,800 patients with de novo three-vessel (3VD) and/or left main ...[more]

PMID: 34669586

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Dataset Information

Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial.

Background

Aims

Methods

Results

Conclusions

Trial registration

Publications

Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial.

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