SYNTAX 评分 II 对行直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者预后的影响：一项四年所有患者登记研究的分析。

Prognostic impact of the SYNTAX score II in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: analysis of a four-year all-comers registry.

机构信息

Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.

出版信息

EuroIntervention. 2019 Oct 4;15(9):e796-e803. doi: 10.4244/EIJ-D-18-00561.

DOI:10.4244/EIJ-D-18-00561

PMID:30175963

Abstract

AIMS

This study aimed to investigate the prognostic impact of the SYNTAX score II (SS-II) on ST-segment elevation myocardial infarction (STEMI) patients undergoing a primary percutaneous coronary intervention (pPCI).

METHODS AND RESULTS

This retrospective cohort study included 1,689 patients with STEMI who underwent pPCI between January 2008 and December 2016. The patients were categorised into three groups based on SS-II tertiles (SS-II low tertile <24 [n=585], SS-II intermediate tertile ≥24 and ≤34 [n=567], and SS-II high tertile >34 [n=537]). In-hospital mortality was significantly lower in patients with low and mid SS-II when compared with high SS-II (0.7% vs 0.5% vs 16.4%, p=0.001). During follow-up (median 2.35 years), a high SS-II was positively correlated with MACE (12.3% for low SS-II vs 18.3% for mid SS-II vs 43.2% for high SS-II, p=0.001), all-cause mortality (1.5% vs 3.9% vs 14.2%, p=0.001) and heart failure (0.3% vs 2.7% vs 8.2%, p=0.001). The SS-II showed additive value on top of GRACE, anatomical SYNTAX score and residual SYNTAX score.

CONCLUSIONS

The SS-II in patients with STEMI undergoing pPCI adds important prognostic information regarding midterm adverse outcomes, being an independent and powerful predictor of MACE, heart failure and all-cause mortality during follow-up.

摘要

目的

本研究旨在探讨 SYNTAX 评分 II（SS-II）对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）患者的预后影响。

方法和结果

本回顾性队列研究纳入了 2008 年 1 月至 2016 年 12 月期间接受 pPCI 的 1689 例 STEMI 患者。根据 SS-II 三分位数将患者分为三组（SS-II 低三分位<24 [n=585]，SS-II 中三分位≥24 且≤34 [n=567]，SS-II 高三分位>34 [n=537]）。与 SS-II 高分组相比，SS-II 低和中分组的住院死亡率显著降低（0.7% vs 0.5% vs 16.4%，p=0.001）。在随访期间（中位数 2.35 年），高 SS-II 与 MACE（SS-II 低分组 12.3% vs 中分组 18.3% vs 高分组 43.2%，p=0.001）、全因死亡率（1.5% vs 3.9% vs 14.2%，p=0.001）和心力衰竭（0.3% vs 2.7% vs 8.2%，p=0.001）显著相关。SS-II 在 GRACE、解剖学 SYNTAX 评分和残余 SYNTAX 评分的基础上提供了附加价值。