关键词: 冠心病, 残存SYNTAX评分, 再次血运重建, 主要不良心脑血管事件

Abstract: Objective  To evaluate the ability of residual SYNTAX to predict longterm prognosis in patients with coronary artery disease. Methods  A total of 311 patients with coronary artery disease undergoing coronary artery disease were enrolled in the Department of Cardiology,  Inner Mongolia Autonomous Region Hospital from January 2013 to May 2014. Clinical data including sex,  age,  clinical diagnosis,  blood lipid and renal function were collected. Main adverse cardiovascular and cerebrovascular events (MACCE),  including allcause death,  stroke,  repeat revascularization,  and heart failure,  were followed up for 2 to 4 years. Results  Of the 311 patients, there were 48 cases of MACCE,  including 14 cases of allcause death,  23 cases of repeat revascularization,  9 cases of ischemic stroke and 2 cases of heart failure. MACCE group was older than nonMACCE group(64.13±8.45 vs 60.79±10.12, P=0.03),  and the ratio of patients with diabetes mellitus was higher than that of the nonMACCE group (39.58% vs 18.63%, P=0.001),  SYNTAX scores (15.16±6.53 and 12.94±7.44), and residual SYNTAX scores  (7.52±6.54 and 4.23±5.50, P=0.000) were significantly higher in MACCE group than those without MACCE group . The area under the curve for predicting the endpoint events about SYNTAX score,  residual SYNTAX score, visualized coronary artery disease were 0.608(P=0.018),  0.665(P=0.000),  0.668(P=0.000) respectively. The incidence of MACCE was 5.98% and 20.42% in complete revascularization group and incomplete revascularization group, with P being 0.003. The revascularization rates of the two groups were 0.85% and 12.37%, respectively(P=0.000). The SYNTAX scores for patients with diabetes mellitus and nondiabetic were 15.09±7.69 and 12.78±7.17, P=0.026,  and the residual SYNTAX scores were 6.15±6.32 and 4.34±5.57, P=0.016. The incidence of MACCE in diabetics and nondiabetic patients was 27.9% and 11.8% (P=0.001),  and the repeat revascularization rates were 19.1% and 4.9%,  respectively(P=0.000). Conclusion  ① The complete revascularization of patients with coronary heart disease is superior to incomplete revascularization,  and the more lesions the residual coronary artery has, the higher the incidence of MACCE is. ② Residual SYNTAX score,  SYNTAX score and visualized coronary artery disease can predict longterm prognosis. ③ The degree of coronary artery disease in patients with diabetes is heavy, and the main reason for the high incidence of MACCE is revascularization.

Key words: coronary disease, residual SYNTAX score, repeat revascularization, Main adverse cardiovascular and cerebrovascular events