TY - JOUR
T1 - The MI SYNTAX score for risk stratification in patients undergoing primary percutaneous coronary intervention for treatment of acute myocardial infarction
T2 - A substudy of the COMFORTABLE AMI trial
AU - Magro, Michael
AU - Räber, Lorenz
AU - Heg, Dik
AU - Taniwaki, Masanori
AU - Kelbaek, Henning
AU - Ostojić, Miodrag
AU - Baumbach, Andreas
AU - Tüller, David
AU - Von Birgelen, Clemens
AU - Roffi, Marco
AU - Pedrazzini, Giovanni
AU - Kornowski, Ran
AU - Weber, Klaus
AU - Meier, Bernhard
AU - Lüscher, Thomas F.
AU - Serruys, Patrick W.
AU - Jüni, Peter
AU - Windecker, Stephan
PY - 2014/8/1
Y1 - 2014/8/1
N2 - Background To investigate the performance of the MI Sxscore in a multicentre randomised trial of patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results The MI Sxscore was prospectively determined among 1132 STEMI patients enrolled into the COMFORTABLE AMI trial, which randomised patients to treatment with bare-metal (BMS) or biolimus-eluting (BES) stents. Patient- (death, myocardial infarction, any revascularisation) and device-oriented (cardiac death, target-vessel MI, target lesion revascularisation) major adverse cardiac events (MACEs) were compared across MI Sxscore tertiles and according to stent type. The median MI SXscore was 14 (IQR: 9-21). Patients were divided into tertiles of Sxscorelow (≤ 10), Sxscoreintermediate (11-18) and Sxscore intermediate (≥ 19). At 1 year, patient-oriented MACE occurred in 15% of the Sxscoreintermediate, 9% of the Sxscore intermediate and 5% of the Sxscoreintermediate tertiles (p < 0.001), whereas device-oriented MACE occurred in 8% of the Sxscore intermediate, 6% of the Sxscoreintermediate and 4% of the Sxscoreintermediate tertiles (p = 0.03). Addition of the MI Sxscore to the TIMI risk score improved prediction of patient- (c-statistic value increase from 0.63 to 0.69) and device-oriented MACEs (c-statistic value increase from 0.65 to 0.70). Differences in the risk for device-oriented MACE between BMS and BES were evident among Sxscoreintermediate (13% vs. 4% HR 0.33 (0.15-0.74), p = 0.007 rather than those in Sxscore intermediate: 4% vs. 3% HR 0.68 (0.24-1.97), p = 0.48) tertiles. Conclusions The MI Sxscore allows risk stratification of patient- and device-oriented MACEs among patients undergoing PPCI. The addition of the MI Sxscore to the TIMI risk score is of incremental prognostic value among patients undergoing PPCI for treatment of STEMI.
AB - Background To investigate the performance of the MI Sxscore in a multicentre randomised trial of patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results The MI Sxscore was prospectively determined among 1132 STEMI patients enrolled into the COMFORTABLE AMI trial, which randomised patients to treatment with bare-metal (BMS) or biolimus-eluting (BES) stents. Patient- (death, myocardial infarction, any revascularisation) and device-oriented (cardiac death, target-vessel MI, target lesion revascularisation) major adverse cardiac events (MACEs) were compared across MI Sxscore tertiles and according to stent type. The median MI SXscore was 14 (IQR: 9-21). Patients were divided into tertiles of Sxscorelow (≤ 10), Sxscoreintermediate (11-18) and Sxscore intermediate (≥ 19). At 1 year, patient-oriented MACE occurred in 15% of the Sxscoreintermediate, 9% of the Sxscore intermediate and 5% of the Sxscoreintermediate tertiles (p < 0.001), whereas device-oriented MACE occurred in 8% of the Sxscore intermediate, 6% of the Sxscoreintermediate and 4% of the Sxscoreintermediate tertiles (p = 0.03). Addition of the MI Sxscore to the TIMI risk score improved prediction of patient- (c-statistic value increase from 0.63 to 0.69) and device-oriented MACEs (c-statistic value increase from 0.65 to 0.70). Differences in the risk for device-oriented MACE between BMS and BES were evident among Sxscoreintermediate (13% vs. 4% HR 0.33 (0.15-0.74), p = 0.007 rather than those in Sxscore intermediate: 4% vs. 3% HR 0.68 (0.24-1.97), p = 0.48) tertiles. Conclusions The MI Sxscore allows risk stratification of patient- and device-oriented MACEs among patients undergoing PPCI. The addition of the MI Sxscore to the TIMI risk score is of incremental prognostic value among patients undergoing PPCI for treatment of STEMI.
KW - Primary percutaneous coronary intervention
KW - ST segment elevation myocardial infarction
KW - SYNTAX score
UR - http://www.scopus.com/inward/record.url?scp=84904264120&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2014.05.029
DO - 10.1016/j.ijcard.2014.05.029
M3 - Article
C2 - 24882698
AN - SCOPUS:84904264120
SN - 0167-5273
VL - 175
SP - 314
EP - 322
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 2
ER -