Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands.
PLoS One. 2018 Jul 2;13(7):e0200076. doi: 10.1371/journal.pone.0200076. eCollection 2018.
SYNTAX score II (SSII) is a long-term mortality prediction model to guide the decision making of the heart-team between coronary artery bypass grafting or percutaneous coronary intervention (PCI) in patients with left main or three-vessel coronary artery disease. This study aims to investigate the long-term predictive value of SSII for all-cause mortality in patients with one- or two-vessel disease undergoing PCI.
A total of 628 patients (76% men, mean age: 61±10 years) undergoing PCI due to stable angina pectoris (43%) or acute coronary syndrome (57%), included between January 2008 and June 2013, were eligible for the current study. SSII was calculated using the original SYNTAX score website (www.syntaxscore.com). Cox regression analysis was used to assess the association between continuous SSII and long-term all-cause mortality. The area under the receiver-operating characteristic curve was used to assess the performance of SSII.
SSII ranged from 6.6 to 58.2 (median: 20.4, interquartile range: 16.1-26.8). In multivariable analysis, SSII proved to be an independent significant predictor for 4.5-year mortality (hazard ratio per point increase: 1.10; 95% confidence interval: 1.07-1.13; p<0.001). In terms of discrimination, SSII had a concordance index of 0.77.
In addition to its established value in patients with left main and three-vessel disease, SSII may also predict long-term mortality in PCI-treated patients with one- or two-vessel disease.
SYNTAX 评分 II（SSII）是一种长期死亡率预测模型，用于指导左主干或三支血管病变患者的心脏团队在冠状动脉旁路移植术或经皮冠状动脉介入治疗（PCI）之间做出决策。本研究旨在探讨 SSII 对接受 PCI 的单支或双支病变患者全因死亡率的长期预测价值。
共有 628 名（76%为男性，平均年龄：61±10 岁）因稳定性心绞痛（43%）或急性冠状动脉综合征（57%）接受 PCI 的患者符合本研究条件。使用原始 SYNTAX 评分网站（www.syntaxscore.com）计算 SSII。使用 Cox 回归分析评估连续 SSII 与长期全因死亡率之间的关联。使用接收者操作特征曲线下面积评估 SSII 的性能。
SSII 范围为 6.6 至 58.2（中位数：20.4，四分位距：16.1-26.8）。多变量分析表明，SSII 是 4.5 年死亡率的独立显著预测因子（每增加 1 分的危险比：1.10；95%置信区间：1.07-1.13；p<0.001）。在判别能力方面，SSII 的一致性指数为 0.77。
除了在左主干和三支血管病变患者中的既定价值外，SSII 还可能预测接受 PCI 治疗的单支或双支病变患者的长期死亡率。
