Evaluation to longterm prognosis by residual SYNTAX score to 311 patients with percutaneous coronary artery intervention
Han Yajun， Zhao Ping， Zhu Hui， Zhao Weiyi， Wang Yanfang， Liu Zhihong
2018, 33(8):
670-674.
doi:10.3969/j.issn.1004-583X.2018.08.006
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Objective To evaluate the ability of residual SYNTAX to predict longterm 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 allcause 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 nonMACCE 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 nonMACCE 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 nondiabetic 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 nondiabetic 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 longterm 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.