Journal
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
Volume 34, Issue 8, Pages 1165-1175Publisher
SPRINGER
DOI: 10.1007/s10554-018-1333-1
Keywords
SYNTAX score II; SYNTAX score; TIMI risk; In-hospital and long-term mortality; ST segment elevation myocardial infarction; Primary percutaneous coronary intervention
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SYNTAX score II (SS-II) has a powerful prognostic accuracy in patients with stable complex coronary artery disease who have undergone revascularization; however, there is limited data regarding the prognosis of patients with ST segment elevation myocardial infarction (STEMI). The aim of this study is to examine both the predictive performance of SS-II in determining in-hospital and long term mortality of STEMI patients and to compare SYNTAX score (SS) and TIMI risk score (TRS). Consecutive 1912 STEMI patients treated with primary percutaneous coronary intervention (p-PCI) retrospectively reviewed, and the remaining 1708 patients constituted the study population after exclusion. The patients were divided into three groups according to increased SS-II value: low (n:562; SS-II <= 24.6); intermediate (n:563; 24.6 < SS-II < 34.4); and high tertile (n:583; SS-II >= 34.4). In-hospital and long term mortality rate from all causes (0 vs. 0.5 vs. 10.6% and 1.8 vs. 3.2 vs. 18.1% respectively, p <= 0.001) were significantly increased with SS-II tertiles and SS-II was found to be independent predictor of in-hospital and long term mortality (HR: 1.076 95% CI 1.060-1.092, p < 0.001) and (HR: 1.070 95% CI 1.050-1.090, p < 0.0001). The predictive power of SS-II, SS, and TRS were compared by ROC curve and decision curve analysis. SS-II surpassed SS and TRS in long-term and in-hospital mortality prediction. SS-II is a powerful tool to predict in-hospital and long-term mortality from all causes in STEMI patients treated with p-PCI.
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