Background The SYNTAX score (SS) is a determinant of outcome in patients undergoing percutaneous coronary intervention. In addition, it has been recently shown that the clinical SYNTAX score (cSS), obtained by adding clinical variables to the SS, improves the predictive power of the resulting risk model. We assessed the hypothesis that the use of the cSS may predict outcomes of patients undergoing coronary artery bypass grafting (CABG). Methods We measured the SYNTAX score in 874 patients undergoing isolated first time on-pump CABG. The clinical SYNTAX score was calculated at the time of the study using age, creatinine clearance and ejection fraction, the modified ACEF score, and analyses performed for major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality at 3-year follow-up. Results The mean age of the study population was 70.9 ± 8.1 years, and the median cSS 14.2 (range 2.1–286.5). The ROC curve analysis showed that a cSS >14.5 (81.4% sensitivity and 67.8% specificity) was a reliable tool in discrimination of patients for the occurrence of MACCE (AUC 0.78) and all-cause mortality (AUC 0.74). Kaplan-Meier survival analysis confirmed that patients belonging to higher cSS quartiles have poorer 3-year survival (P =.0001) and MACCE-free survival (P =.0001), with respect to those with lower cSS. Conclusions This observational study has shown that the clinical SYNTAX score, incorporating the lesion-based SS and clinical-based ACEF score, predicted mid-term adverse outcomes of patients undergoing CABG and may play an important role in the risk stratification of this population. Further studies are needed to confirm these findings.

Clinical SYNTAX score predicts outcomes of patients undergoing coronary artery bypass grafting / Melina, Giovanni; Angeloni, Emiliano; Refice, Simone; Monti, Francesco; Serdoz, Roberto; Rosato, Stefano; Seccareccia, Fulvia; Colivicchi, Furio; Serdoz, Roberta; Paneni, Francesco; Sinatra, Riccardo. - In: AMERICAN HEART JOURNAL. - ISSN 0002-8703. - STAMPA. - 188:(2017), pp. 118-126. [10.1016/j.ahj.2017.03.016]

Clinical SYNTAX score predicts outcomes of patients undergoing coronary artery bypass grafting

Melina, Giovanni;Sinatra, Riccardo
2017

Abstract

Background The SYNTAX score (SS) is a determinant of outcome in patients undergoing percutaneous coronary intervention. In addition, it has been recently shown that the clinical SYNTAX score (cSS), obtained by adding clinical variables to the SS, improves the predictive power of the resulting risk model. We assessed the hypothesis that the use of the cSS may predict outcomes of patients undergoing coronary artery bypass grafting (CABG). Methods We measured the SYNTAX score in 874 patients undergoing isolated first time on-pump CABG. The clinical SYNTAX score was calculated at the time of the study using age, creatinine clearance and ejection fraction, the modified ACEF score, and analyses performed for major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality at 3-year follow-up. Results The mean age of the study population was 70.9 ± 8.1 years, and the median cSS 14.2 (range 2.1–286.5). The ROC curve analysis showed that a cSS >14.5 (81.4% sensitivity and 67.8% specificity) was a reliable tool in discrimination of patients for the occurrence of MACCE (AUC 0.78) and all-cause mortality (AUC 0.74). Kaplan-Meier survival analysis confirmed that patients belonging to higher cSS quartiles have poorer 3-year survival (P =.0001) and MACCE-free survival (P =.0001), with respect to those with lower cSS. Conclusions This observational study has shown that the clinical SYNTAX score, incorporating the lesion-based SS and clinical-based ACEF score, predicted mid-term adverse outcomes of patients undergoing CABG and may play an important role in the risk stratification of this population. Further studies are needed to confirm these findings.
aged; cause of death; coronary artery bypass; coronary artery disease; echocardiography; elective surgical procedures; female; follow-up studies; humans; italy; kaplan-meier estimate; male; roc curve; reproducibility of results; retrospective studies; risk factors; severity of illness index; stroke volume; survival rate; switzerland; time factors; treatment outcome; ventricular function, left; risk assessment; cardiology and cardiovascular medicine
01 Pubblicazione su rivista::01a Articolo in rivista
Clinical SYNTAX score predicts outcomes of patients undergoing coronary artery bypass grafting / Melina, Giovanni; Angeloni, Emiliano; Refice, Simone; Monti, Francesco; Serdoz, Roberto; Rosato, Stefano; Seccareccia, Fulvia; Colivicchi, Furio; Serdoz, Roberta; Paneni, Francesco; Sinatra, Riccardo. - In: AMERICAN HEART JOURNAL. - ISSN 0002-8703. - STAMPA. - 188:(2017), pp. 118-126. [10.1016/j.ahj.2017.03.016]
File allegati a questo prodotto
File Dimensione Formato  
Melina_Clinical_2017.pdf

solo gestori archivio

Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 586.83 kB
Formato Adobe PDF
586.83 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1071996
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 8
social impact