Lemesle Gilles, Bonello Laurent, de Labriolle Axel, Steinberg Daniel H, Roy Probal, Pinto Slottow Tina L, Torguson Rebecca, Kaneshige Kimberly, Xue Zhenyi, Suddath William O, Satler Lowell F, Kent Kenneth M, Lindsay Joseph, Pichard Augusto D, Waksman Ron
Division of Cardiology, Washington Hospital Center, USA.
Catheter Cardiovasc Interv. 2009 Apr 1;73(5):612-7. doi: 10.1002/ccd.21883.
The Syntax score prognostic value has recently been highlighted in patients undergoing percutaneous coronary intervention (PCI) for multivessel coronary artery disease (CAD), however its prognostic value in patients undergoing coronary artery bypass grafting (CABG) for multivessel CAD is still unknown. The aim of this study was to evaluate the prognostic value of the Syntax score in patients undergoing CABG for 3-vessel CAD.
A cohort of 320 consecutive patients with multivessel (3-vessel) CAD who were subjected for CABG were included in this study and divided into tertiles according to the Syntax score (<24.5, 24.5-34, and >34). During the 1-year follow-up, cardiovascular events including death, myocardial infarction (MI), and stroke were systematically indexed. The primary end point was the composite criteria death/MI/stroke.
The Syntax score ranged from 11-74 with a mean of 31.2 +/- 12.6 and a median of 28.5 [22-38]. Baseline clinical characteristics were similar among the tertiles. No statistical difference was found for the composite criteria death/MI/stroke: 9.4% versus 7.5% versus 10.4% in the groups with a Syntax score <24.5, 24.5-34, and >34, respectively (P = 0.754).
Unlike for PCI, the Syntax score has a poor prognostic value for severe cardiovascular events in patients undergoing CABG for 3-vessel CAD. Other risk scores should be used to predict the outcome of this population.
近期，在接受经皮冠状动脉介入治疗（PCI）的多支冠状动脉疾病（CAD）患者中，Syntax评分的预后价值已得到凸显，然而其在接受冠状动脉旁路移植术（CABG）治疗的多支CAD患者中的预后价值仍不明确。本研究旨在评估Syntax评分在接受三支血管CAD的CABG患者中的预后价值。
本研究纳入了320例连续接受CABG治疗的多支（三支血管）CAD患者，并根据Syntax评分（<24.5、24.5 - 34和>34）分为三分位数组。在1年的随访期间，系统记录包括死亡、心肌梗死（MI）和中风在内的心血管事件。主要终点是死亡/MI/中风的综合标准。
Syntax评分范围为11 - 74，平均为31.2 +/- 12.6，中位数为28.5 [22 - 38]。三分位数组之间的基线临床特征相似。在死亡/MI/中风综合标准方面未发现统计学差异：Syntax评分<24.5、24.5 - 34和>34的组中分别为9.4%、7.5%和10.4%（P = 0.754）。
与PCI不同，Syntax评分在接受三支血管CAD的CABG患者中对严重心血管事件的预后价值较差。应使用其他风险评分来预测该人群的预后。
