The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: A substudy of the resolute all comers trial

Scot Garg, Patrick W. Serruys, Sigmund Silber, Joanna Wykrzykowska, Robert Jan Van Geuns, Gert Richardt, Pawel E. Buszman, Henning Kelbæk, Adrianus Johannes Van Boven, Sjoerd H. Hofma, Axel Linke, Volker Klauss, William Wijns, Carlos MacAya, Philippe Garot, Carlo Dimario, Ganesh Manoharan, Ran Kornowski, Thomas Ischinger, Antonio BartorelliEric Van Remortel, Jacintha Ronden, Stephan Windecker

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstrakt

    Objectives: This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents. Background: The SXscore can identify patients treated with PCI who are at highest risk of adverse events. Methods: The SXscore was calculated prospectively in 2,033 of the 2,292 patients enrolled in the RESOLUTE All Comers study (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention). Clinical outcomes in terms of a patient-oriented composite endpoint (POCE) of all-cause death, myocardial infarction (MI), and repeat revascularization; the individual components of POCE; target lesion failure (TLF) (a composite of cardiac death, target-vessel MI, and clinically driven target lesion revascularization); and stent thrombosis were subsequently stratified according to SXscore tertiles: SXscoreLOW ≤9 (n = 698), 9 <SXscoreMID ≤17 (n = 676); SXscoreHIGH >17 (n = 659). Results: At 12-month follow-up, rates of POCE, MI, repeat revascularization, TLF, and the composite of death/MI were all significantly higher in patients in the highest SXscore tercile. Rates of stent thrombosis were all highest in the SXscoreHIGH tertile (p > 0.05). After multivariate adjustment, the SXscore was identified as an independent predictor of POCE, MI, repeat revascularization, and TLF (p < 0.05 for all). At 12-month follow-up, the SXscore, ACEF score, and Clinical SXscore had C-statistics of 0.57, 0.78, and 0.67, respectively, for mortality and of 0.62, 0.56, 0.63, respectively, for POCE. No significant between-stent differences were observed for TLF or POCE in any of the SXscore tertiles. Conclusions: The SYNTAX score is able to stratify risk amongst an all-comers population treated with PCI with second-generation drug-eluting stents (DES); however, improvements can be made with the inclusion of clinical variables. (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084)

    OriginalsprogEngelsk
    Sider (fra-til)432-441
    Antal sider10
    TidsskriftJACC: Cardiovascular Interventions
    Vol/bind4
    Udgave nummer4
    DOI
    StatusUdgivet - 1 apr. 2011

    Fingeraftryk Udforsk hvilke forskningsemner 'The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: A substudy of the resolute all comers trial' indeholder.

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