Impact of the SYNTAX Score on Risk Stratification after Percutaneous Coronary Intervention in Non-Selected Patients

ABSTRACTBACKGROUNDThe SYNTAX score was developed as an angiographic tool to grade the complexity of coronary artery disease in patients with three-vessel and/or left main disease. We evaluated its role in predicting clinical outcomes after percutaneous coronary intervention (PCI) in non-selected patients, treated in the daily clinical practice of a reference center.METHODSAnalysis of patients undergoing PCI from March to September 2009 and followed-up for up to 12 months. Patients were divided in tertiles according to the SYNTAX score. The primary endpoint included major adverse cardiac events (MACE) – death, non-fatal acute myocardial infarction and target-vessel revascularization. The ability of the SYNTAX score in predicting MACE was assessed by the ROC (Receiver Operator Characteristic) curve.RESULTSTwo hundred and thirty-four patients with a mean SYNTAX score of 11.6±6.2 points were included. Tertile I had a SYNTAX score ≤9 (average 5.9); tertile II, > 9 and≤13 (average 10.8); and tertile III, > 13 (average 18.3). In the clinical follow-up of 7.2±4.9months, the incidence of MACE was greater in tertile III when compared to tertiles I and II (2.5% vs. 6.4% vs. 14.1%; P=0.0075). The ROC curve showed an area under the curve of 0.667 (P=0.012) indicating a moderate ability to anticipate the occurrence of MACE in this population.CONCLUSIONSThe SYNTAX score proved to be useful in predicting the occurrence of MACE after PCI in real world patients