Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang Ming University, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
School of Medicine, National Yang Ming University, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan.
Clin Chim Acta. 2015 May 20;445:93-100. doi: 10.1016/j.cca.2015.03.029. Epub 2015 Mar 27.
Whether angiographic coronary severity really predicts future major adverse cardiovascular events (MACEs) in patients with coronary artery disease (CAD) is uncertain. Few studies have compared the efficacy of SYNTAX, Gensini and Jeopardy scores in predicting MACE in stable CAD.
We collected data of MACE, including all-cause mortality, all strokes, new myocardial infarction and unplanned repeat revascularization, in subjects with stable CAD from our catheterization databank. Coronary severity was graded with SYNTAX, Gensini and Jeopardy scoring systems.
During a median follow-up period of 42months, 39 out of the 181 subjects developed at least 1 MACE. Those with MACE had a significantly higher baseline high sensitivity C-reactive protein (hs-CRP) (p=0.025). Multivariate analysis showed that coronary severity score, hs-CRP and diabetes mellitus were significant predictors for MACE. Kaplan-Meier estimates showed a significant difference in MACE-free rates between SYNTAX binary scores (≥15 vs. <15, p=0.043), Gensini binary scores (≥36 vs. <36, p=0.048) and Jeopardy binary scores (≥4 vs. <4, p=0.001).
Coronary severity score, hs-CRP and diabetes mellitus independently predicted MACE in patients with stable CAD. The Jeopardy score is simple to calculate and as effective for predicting MACE in stable CAD as the complex SYNTAX score.
血管造影冠状动脉严重程度是否真的可以预测患有冠状动脉疾病（CAD）患者的未来主要不良心血管事件（MACE）尚不确定。很少有研究比较 SYNTAX、Gensini 和 Jeopardy 评分在预测稳定型 CAD 患者中的 MACE 的疗效。
我们从我们的导管数据库中收集了稳定型 CAD 患者的 MACE 数据，包括全因死亡率、所有中风、新发心肌梗死和计划外再次血运重建。使用 SYNTAX、Gensini 和 Jeopardy 评分系统对冠状动脉严重程度进行分级。
在中位数为 42 个月的随访期间，181 名患者中有 39 名发生了至少 1 次 MACE。发生 MACE 的患者基线高敏 C 反应蛋白（hs-CRP）显著更高（p=0.025）。多变量分析表明，冠状动脉严重程度评分、hs-CRP 和糖尿病是 MACE 的显著预测因素。Kaplan-Meier 估计显示，SYNTAX 二分位数评分（≥15 与 <15，p=0.043）、Gensini 二分位数评分（≥36 与 <36，p=0.048）和 Jeopardy 二分位数评分（≥4 与 <4，p=0.001）之间的 MACE 无事件率有显著差异。
冠状动脉严重程度评分、hs-CRP 和糖尿病独立预测稳定型 CAD 患者的 MACE。Jeopardy 评分计算简单，在预测稳定型 CAD 中的 MACE 方面与复杂的 SYNTAX 评分一样有效。
