Prognostic Value of Anatomical SYNTAX Score and SYNTAX Score II in Veterans With Left Main and/or Three-Vessel Coronary Artery Disease

Naoki Misumida, Ahmed Elsharawy Ahmed, Mariah Barlow, Rachel Goodwin, Elliot Goodwin, Ameer Musa, Mohammad Mathbout, Gbolahan Ogunbayo, Sun Moon Kim, Ahmed Abdel-Latif, Khaled M. Ziada

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Anatomical SYNTAX score (SS1) and SYNTAX score II (SS2) are often utilized to determine the optimal revascularization strategy. Although US veterans have unique characteristics that may affect outcomes after revascularization, the prognostic values of SS1 and SS2 in veterans have not yet been validated. We performed a retrospective analysis of consecutive veteran patients who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main and/or 3-vessel disease from 2009 to 2014. SS1 and SS2 were calculated for each patient. The primary outcome was all-cause mortality. The prognostic values of SS1 and SS2 were compared by receiver operating characteristic curve analysis. The predicted 4-year mortality derived from SS2 was compared with the observed 4-year mortality estimated from Kaplan-Meier analysis. After exclusion, 286 patients (99% male) were included. Among 286 patients, 79 patients (27.6%) had left main disease, 151 (52.8%) underwent PCI, and 135 (47.2%) underwent CABG. Overall mortality was 27.6% at a median follow-up of 5.0 years. SS2 had better discriminative ability for all-cause mortality than SS1 (c-index 0.79 vs 0.52, p <0.001). Observed and predicted 4-year mortality correlated well in patients with low and intermediate SS2 in both PCI and CABG cohorts, but observed mortality was higher than predicted in the PCI cohort with high SS2 (observed 54.7% vs predicted 40.5%). In conclusion, observed and predicted 4-year mortality derived from SS2 correlated well in patients with low and intermediate SS2, but SS2 underestimated mortality in the PCI cohort with high SS2.

Original languageEnglish
Pages (from-to)213-219
Number of pages7
JournalAmerican Journal of Cardiology
Volume122
Issue number2
DOIs
StatePublished - Jul 15 2018

Bibliographical note

Funding Information:
Dr. Abdel-Latif is supported by the University of Kentucky COBRE Early Career Program (Lexington, Kentucky) grant P20 GM103527 and the National Institutes of Health (Bethesda, Maryland) grant R01 HL124266.

Funding Information:
Dr. Abdel-Latif is supported by the University of Kentucky COBRE Early Career Program (Lexington, Kentucky) grant P20 GM103527 and the National Institutes of Health (Bethesda, Maryland) grant R01 HL124266 .

Publisher Copyright:
© 2018 Elsevier Inc.

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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