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syntax score predicts clinical outcome in patients with three-vessel coronary artery disease undergoing percutaneous coronary intervention

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Chinese Medical Journal 2011年第5期124卷 704-709页

作者： HE Ji-qiang GAO Yue-chun YU Xian-peng ZHANG Xiao-ling LUO Ya-wei WU Chang-yan LI Yu ZHANG Wei-dong CHEN Fang LU Shu-zheng Department of Cardiology Beijing An Zhen Hospital Capital Medical University & Institution of Beijing Heart Lung and Vascular Disease Beijing 100029 China

Background The syntax score was recently developed as a comprehensive, angiographic tool grading the complexity of coronary artery disease （CAD）. It aims to assist in patient selection and risk stratification of patients with extensive CAD undergoing revascularization. However, the prognostic value of the syntax score in patients undergoing percutaneous coronary intervention （PCI） has not been validated. The aim of this study was to evaluate its role in predicting long-term incidences of major adverse cardiac and cerebrovascular events （MACCE） in patients undergoing PCI for 3-vessel *** Two hundred and three consecutive patients with de novo 3-vessel CAD undergoing PCI with sirolimus-eluting stents were studied. Their angiograms were scored according to the syntax score. The patients were divided into tertiles according to the syntax score： lowest syntax score tertile （syntax score 〈22）, intermediate syntax score tertile （syntax score of 23 to 32）, and the highest syntax score tertile （syntax score 〉33）. During the 1-year follow-up, the MACCE-free survival curves were estimated by the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the relation between the syntax score and the incidence of MACCE. Performance of the syntax score was studied with respect to predicting the rate of MACCE by receiver operator characteristic （ROC） curves with an area under the *** The overall syntax score ranged from 6 to 66 with mean ± standard deviation of 27.9±12.6 and a median of 26. At 1 year, the syntax score significantly predicted the risk of MACCE （HR 1.07/U increase, 95% Cl 1.04 to 1.11, P 〈0.001）. The rate of MACCE was significantly increased among patients in the highest syntax score tertile （17.9%） as compared with those with the lowest syntax score tertile （1.4%, P 〈0.001） or intermediate syntax score tertile （6.2%, P=0.041）. After the adjustment for all potential confounders, the S

关键词： syntax score 3-vessel coronary artery disease percutaneous coronary intervention

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The syntax score as a predictor of contrast-induced nephropathy patients with chronic total occlusion undergoing percutaneous coronary intervention

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South China Journal of Cardiology 2018年第2期19卷 124-129,142页

作者：吐尔逊江阿布都艾尼刘勇陈世群孙国立赛米热木合塔尔郭晓升李华龙冉鹏杨峻青谭宁周颖玲陈纪言 Department of Cardiology Guangdong Cardiovascular Institute Guangdong Key Laboratory of Coronary Disease Guangdong General Hospital Guangdong Academy of Medical Sciences Guangdong General Hospital Zhuhai Hospital Zhuhai Golden Bay Center Hospital School of Medicine South China University of Technology

Background The syntax score was developed to assess the severity and complexity of coronary artery disease and was determined to be effective in predicting contrast-induced nephropathy（CIN） in patients with STelevation myocardial infarction（STEMI） and non-STEMI（NSTEMI）. However, the relationship between syntax score and CIN of patients with CTO undergoing PCI has been unclear. Methods We retrospectively enrolled 667 patients with CTO who underwent our institution′s basic PCI protocol between January 2010 and September 2012. The patients were divided into 3 groups： a low-risk group（syntax score 〈 23; n = 231）, a moderate-risk group（syntax score = 23-32; n = 214）, and a high-risk group（syntax score〉32; n = 222）. CIN was defined as an absolute increase in SCr of ≥ 0.5 mg/d L over baseline values within 48-72 h after administration of contrast medium. We observed the correlation between syntax score and the CIN rates. Results CIN developed in 74（11.09%） of the 667 study patients. The CIN rate showed a positive trend in the 3 groups based on the syntax score, the higher syntax score corresponds to the higher incidence of CIN（6.93%,13.08%,13.51%P = 0.044）. In the multivariate analysis, syntax score was identified as an independent predictor of CIN（OR：1.956,95% CI： 1.014-3.773; P = 0.045; OR： 1.942,95% CI： 1.005-3.752; P = 0.048）. The incidence of in-hospital（1.3% vs. 4, 21% vs. 5.86%, P = 0.035） and long-term MACE（4.59% vs. 7.88% vs. 11.66%, P = 0.046） rates were more frequent in the higner syntax score groups. Conclusions syntax score is an independent predictor of CIN among patients with CTO undergoing PCI.

关键词： chronic total occlusion contrast-induced nephropathy percutaneous coronary intervention syntax score

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Value of GRACE and syntax scores for predicting the prognosis of patients with non-ST elevation acute coronary syndrome

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World Journal of Clinical Cases 2021年第33期9卷 10143-10150页

作者： Xiao-Feng Wang Ming Zhao Fei Liu Guo-Rong Sun Department of Cardiology Cangzhou Central HospitalCangzhou 061000Hebei ProvinceChina

BACKGROUND GRACE and syntax scores are important tools to assess prognosis in non-STelevation acute coronary syndrome(NSTE-ACS).However,there have been few studies on their value in patients receiving different types of *** To explore the value of GRACE and syntax scores in predicting the prognosis of patients with NSTE-ACS receiving different types of *** The data of 386 patients with NSTE-ACS were retrospectively analyzed and categorized into different groups.A total of 195 patients who received agents alone comprised the medication group,156 who received medical therapy combined with stents comprised the stent group,and 35 patients who were given agents and underwent coronary artery bypass grafting(CABG)comprised the CABG *** information was compared among the three *** and syntax scores were *** association between the relationship between GRACE and syntax scores and the occurrence of major adverse cardiovascular events(MACEs)was ***’s correlation analysis was used to determine the factors influencing prognosis in patients with *** and multivariate analyses were conducted to analyze the predictive value of GRACE and syntax scores for predicting prognosis in patients with NSTE-ACS using the Cox proportional-hazards *** The incidence of MACE increased with the elevation of GRACE and syntax scores(all Pscore in the medication group,stent group,and CABG group,respectively(Pscore in the medication group,stent group,and CABG group,respectively(P>0.05).The incidence of MACE was

关键词： GRACE score syntax score Non-ST elevation acute coronary syndrome Prognosis

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Calculation of Coronary Angiographic Total Blush in Patients with Coronary Artery Disease and its Prognostic Implication

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Chinese Medical Journal 2015年第18期128卷 2485-2490页

作者： Jing-Jing Gai Lu-Yue Gai Jian-Jun Yan Qin-Hua Jin Department of Cardiology Chinese People's Liberation Army General Hospital Beijing 100853 China

Background： Myocardial perfusion grade （MPG） is an accepted method of evaluating myocardial perfilsion. However, it does not take into the account, the extent of the perfusion. We hypothesized that myocardial blush area times MPG （total blush） would be more accurate than simple MPG, and yield better prognostic information. Methods： About 34 patients were recruited alter they had consented to both coronary angiography （CAG） and single photon emission computed tomography （SPECT）, and divided into two groups. A special dedicated computer was employed to calculate the total blush. The CAG was performed as a conventional way. Scintigraphic technetium 99m methoxyisobutyl-isonitrile rest and stress images were evaluated quantitatively. The comparison was made between stenosis versus chronic total occlusion （CTO）, MPG 1, 2 versus MPG 3, percutaneous intervention （PC1） successful versus failure. A correlation was made between ejection traction （EF） and myocardial perfusion by MPG, total blush, SPECT, and syntax score. Results： The perfusion indices of total blush, summed difference score （SDS） and syntax score were insignificant between the two groups （P 〉 0.05）. However, the left ventricular end diastolic volume was significantly larger in CTO （P 〈 0.05）. The patients with stenosis had better MPG than with CTO （P 〈 0.05）. The increased MPG was associated with increased total blush, higher syntax score, and EF （P 〈 0.05）. Successful PCI resulted in better perfusion indicated by increased total blush, and MPG （P 〈 0.05） but successful PC1 did not change syntax score. EF and SDS significantly. Multivariate linear analysis with EF as the dependent factor and syntax score, SDS, total blush, blush area, and MPG as the independent factors showed a significantly higher degree of correlation （R = 0.87, P 〈 0.05）. Conclusion： Alter PCI the total blush and EF improved significantly indicating its potential application in the thture.

关键词： Coronary Heart Disease: Ejection Fraction Myocardial Perfusion Percutaneous Coronary Intervention: Single PhotonEmission Computed Tomography syntax score

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Role of ADAMTS-5 Expression in the Prognosis of Patients with Coronary Artery Disease: A Single Retrospective Analysis

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International Journal of Clinical Medicine 2023年第11期14卷 487-504页

作者： Hailin Pan Jinguang Liu Department of Cardiology Huizhou Municipal People’s Hospital Huizhou China

This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD). 595 patients admitted to our hospital were selected. Initially, the serum ADAMTS-5 levels of subjects were analyzed. Subsequently, a receiver operating characteristic (ROC) curve was constructed. Furthermore, the serum levels of ADAMTS-5 were assessed in patients, and based on CAD severity, they were categorized into stable angina pectoris (SAP), unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) groups, with the aim of examining the relationship between ADAMTS-5 levels and CAD severity. Differences in clinical outcomes between patients with high and low levels of ADAMTS-5 were analyzed during the follow-up period. The study found that the serum levels of ADAMTS-5 were significantly higher in the group of patients with coronary artery disease (CAD) compared to the group without CAD, indicating its potential as a diagnostic marker for CAD. The ADAMTS-5 levels in the serum of STEMI patients were higher than those with SAP, while NSTEMI patients showed higher levels of ADAMTS-5 than the UA group. There was a positive correlation between serum ADAMTS-5 levels and the syntax score in CAD patients, suggesting a potential association with adverse clinical outcomes in patients with acute myocardial infarction (AMI). This study indicates that ADAMTS-5 shows promise as a biomarker for CAD and highlights the need for further research and validation.

关键词： Coronary Artery Disease syntax score ADAMTS-5 Prognosis Diagnosis

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Validity of QRS Configuration and Myeloperoxidase Level as Determinants of CAD Severity and Prognosis in Patients with STEMI

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World Journal of Cardiovascular Diseases 2021年第1期11卷 82-97页

作者： Wael Ali Khalil Mohamed Abdou Abdelhamed Ahmed S. Eldamanhory Cardiology Department Faculty of Medicine Zagazig University Zagazig Egypt

Background: Terminal QRS distortion and fragmentation (fQRS) with elevated myeloperoxidase (MPO) were linked to poor cardiovascular outcomes in acute coronary syndrome. We aimed to investigate these parameters in early prediction of coronary artery disease severity based on SYNTAX score and in-hospital adverse events in STEMI patients. Methods: A total of 215 patients with first STEMI admitted for primary PCI were included in the study. They were divided according to the admission ECG into group I with QRS distortion or fQRS, group II with combined QRS distortion and fQRS, and group III without QRS distortion or fQRS. Myeloperoxidase and troponin I levels, ST resolution ratio, left ventricular EF%, and severity of coronary artery lesions using SYNTAX risk score were measured. Results: MPO level, SYNTAX score, and in-hospital mortality were higher in group I and II and were higher in group II compared to group I. By regression analysis, QRS distortion, fQRS, and MPO > 412 ng/ml were independent predictors of both CAD severity and in-hospital mortality. DM was an independent predictor of CAD severity (OR: 2.851, P 0.012) while high SYNTAX score was an independent predictor of in-hospital mortality (OR: 6.113, P 0.001). Adding MPO level to any QRS configuration pattern increased predictive value for the detection of CAD severity that was more evident in the combined QRS distortion and fragmentation. Conclusion: Terminal QRS distortion, fragmentation, or combined QRS distortion and fragmentation have a significant value in predicting in-hospital adverse events and CAD severity

关键词： QRS Distortion QRS Fragmentation Myeloperoxidase Level syntax score ST-Elevation Myocardial Infarction

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C-reactive protein/albumin ratio as a predictor for severe coronary artery disease in patients with stable angina pectoris

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South China Journal of Cardiology 2020年第2期21卷 86-90,122页

作者：林旭城陈兰许贤彬 Cardiovascular department Chaozhou central hospitalChaozhou 521000GuangdongChina

Background syntax score(SS),an angiographic tool to grade the complexity of coronary artery disease,has prognostic importance for this disease. C-reactive protein(CRP)and albumin are indicators of *** both of them are associated with high SS. Hence,we aimed to investigate whether baseline CRP to albumin ratio(CAR)is associated with SS. Method A total of 312 consecutive patients with stable angina pectoris,who underwent coronary angiography for suspected coronary artery disease(CAD)from January 2018 to May 2019,were classified into two groups,low score group(syntax score≤22)and high score group(syntax group>22).The Multivariate logistic analysis and ROC curve were performed to detect the predictive effect of CAR for higher SS. Results There are 163 cases in the low score group while 149 cases in the high score group. CAR in the high score group was significantly higher than the other group(5.6[2.8-9.6]vs. 2.5[1.7-5.2],Psyntax score. ROC curve analyses reveal the good predictive values of CAR(AUC 0.731,95% CI:0.608-0.814,Psyntax score and statistical significant better than CRP or albumin alone. Conclusions CAR is independently associated with the complexity and severity of CAD,which has better predictive value than CRP or albumin alone.

关键词： C-reactive protein albumin stable angina pectoris syntax score

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无保护左主干末端病变药物洗脱支架置入和旁路移植治疗的对照研究

无保护左主干末端病变药物洗脱支架置入和旁路移植治疗的对照研究

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作者：包哈申延边大学

学位级别：硕士

目的：无保护左主干(Unprotected left main coronary artery, ULMCA)末端病变患者是冠状动脉粥样硬化性心脏病(简称冠心病)的高危人群,在以往的治疗策略选择中冠状动脉旁路移植(Coronary artery bypass grafting, CABG)是首选治疗方法... 详细信息

目的：无保护左主干(Unprotected left main coronary artery, ULMCA)末端病变患者是冠状动脉粥样硬化性心脏病(简称冠心病)的高危人群,在以往的治疗策略选择中冠状动脉旁路移植(Coronary artery bypass grafting, CABG)是首选治疗方法,然而在实际的临床工作中,由于CABG手术创伤大、术后恢复时间长等因素以至于多数患者坚持选择经皮冠状动脉介入治疗(Percutaneous coronary intervention, PCI),目前对这两种治疗方式临床疗效的对比研究较少。我们回顾性分析ULMCA末端病变应用PCI-DES治疗和CABG治疗的近期、远期、晚期临床疗效,并探讨应用欧洲心脏手术危险评估系统(European system for cardiac operative risk evaluation, Euroscore)及syntax score系统来评估病变风险与临床事件的相关性,为选择更好的治疗方式提供依据。方法：回顾性收录2005年1月至2008年12月在首都医科大学附属北京安贞医院经PCI-DES和CABG治疗的资料保存完整的106例ULMCA末端病变患者,收集患者基线特征,包括性别,年龄,危险因素,生化检查,心电图,超声心动图,冠状动脉造影结果,治疗情况等资料。观察近期、远期及晚期全因死亡、非致死性心肌梗死、靶血管重建及复合终点事件发生情况。结果：1. PCI-DES与CABG两组在性别、年龄、吸烟、血脂、高血压病、糖尿病、左心室射血分数降低、慢性阻塞性肺部疾病、血运重建术前及术后药物治疗、随访时间等基线特征方面相似(P>0.05)。2.两组患者在全因死亡、非致死性心肌梗死、靶血管血运重建及复合终点事件发生率在近期、远期及晚期无统计学差别(P>0.05)。3.在非随机入组的CABG和PCI-DES两组间Euroscore和syntax score两个评分都有统计学差别(P值分别为0.038,0.004),CABG组评分显著高于PCI-DES组。4. PCI-DES和CABG两组患者总的复合终点事件发生率无统计学差别(P=0.977),无复合终点事件生存率和无靶血管重建生存率无统计学差别(P值分别为0.899和0.942)。5.用Euroscore系统把PCI-DES和CABG两组患者分为高危组(≥5.0)和低危组(syntax score系统把PCI-DES和CABG两组患者重新分为高危组(≥27.0)和低危组(score≥5.0同时syntax score≥27.0的极高危患者中CABG组无复合终点事件生存率优于PCI-DES组,但统计学无差别(P=0.449)。8. Euroscore≥5.0是影响CABG疗效的独立危险因素(P=0.027)。syntax score≥27.0是影响PCI-DES疗效的独立危险因素(P=0.020)。结论：ULMCA末端病变患者Euroscore≥5.0时选择PCI-DES治疗与CABG相比获益更大;syntax score≥27.0时选择CABG治疗的获益优于PCI-DES治疗;Euroscore≥5.0是影响CABG疗效的独立危险因素,syntax

关键词：无保护左主干药物洗脱支架冠状动脉旁路移植 Euroscore syntax score

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