Ayça Burak, Akın Fatih, Celik Omer, Cetin Sükrü, Sahin Irfan, Gülşen Kamil, Kalyoncuoğlu Muhsin, Katkat Fahrettin, Okuyan Ertuğrul, Dinçkal Mustafa Hakan
Bağcılar Education and Research Hospital, Turkey.
Kardiol Pol. 2014;72(9):806-13. doi: 10.5603/KP.a2014.0064. Epub 2014 Mar 27.
SYNTAX score (SxS) has been demonstrated to predict long-term outcomes in stable patients with coronary artery disease. But its prognostic value for patients with acute coronary syndrome remains unknown.
To evaluate whether SxS could predict in-hospital outcomes for patients admitted with ST elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (pPCI).
The study included 538 patients with STEMI who underwent pPCI between January 2010 and December 2012. The patients were divided into two groups: low SxS (< 22) and high SxS (> 22). The SxS of all patients was calculated from aninitial angiogram and TIMI flow grade of infarct related artery was calculated after pPCI. Left ventricular systolic functions of the patients were evaluated with an echocardiogram in the following week. The rates of reinfarction and mortality during hospitalisation were obtained from the medical records of our hospital.
The high SxS group had more no-reflow (41% and 25.1%, p < 0.001, respectively), lower ejection fraction (38.2 ± 7.5% and 44.6 ± 8.8%, p < 0.001, respectively), and greater rates of re-infarction (9.5% and 7.3%, p = 0.037, respectively) and mortality (0.9% and 0.2%, p = 0.021, respectively) during hospitalisation compared to the low SxS group. On multivariate logistic regression analysis including clinical variables, SxS was an independent predictor of no-reflow (OR 1.081, 95% CI 1.032-1.133, p = 0.001).
SxS is a useful tool that can predict in-hospital outcomes of patients with STEMI undergoing pPCI.
SYNTAX评分（SxS）已被证明可预测稳定型冠心病患者的长期预后。但其对急性冠状动脉综合征患者的预后价值仍不清楚。
评估SxS能否预测接受直接经皮冠状动脉介入治疗（pPCI）的ST段抬高型心肌梗死（STEMI）患者的住院结局。
该研究纳入了2010年1月至2012年12月期间接受pPCI的538例STEMI患者。患者分为两组：低SxS组（<22）和高SxS组（>22）。所有患者的SxS根据初始血管造影计算得出，梗死相关动脉的TIMI血流分级在pPCI后计算。在接下来的一周内，通过超声心动图评估患者的左心室收缩功能。住院期间的再梗死率和死亡率从我院的病历中获取。
与低SxS组相比，高SxS组住院期间无复流发生率更高（分别为41%和25.1%，p<0.001）、射血分数更低（分别为38.2±7.5%和44.6±8.8%，p<0.001）、再梗死率更高（分别为9.5%和7.3%，p = 0.037）以及死亡率更高（分别为0.9%和0.2%，p = 0.021）。在纳入临床变量的多因素logistic回归分析中，SxS是无复流的独立预测因子（OR 1.081，95%CI 1.032 - 1.133，p = 0.001）。
SxS是一种有用的工具，可预测接受pPCI的STEMI患者的住院结局。
