Yang Hua, Zhang Li, Xu Chen Hong
Department of Cardiology.
Department of Dermatology, Jingzhou Central Hospital, the Second Clinical Medical College, Yangtze University, Jingzhou, Hubei, China.
Medicine (Baltimore). 2019 Jan;98(2):e14043. doi: 10.1097/MD.0000000000014043.
As the SYNTAX Score has limitations, it should be replaced by another better angiographic tool. By comparing mortality that was observed following percutaneous coronary intervention (PCI) in patients who were allotted a low versus a high score, we aimed to systematically investigate mortality prediction using the SYNTAX Score II in Interventional Cardiology.
Electronic databases were searched for relevant publications using the terms "SYNTAX Score II and percutaneous coronary intervention." The main outcome was all-cause mortality. This analysis was carried out by the RevMan 5.3 software [risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated].
A total number of 9443 participants were enrolled for this analysis. As different studies reported different range of SYNTAX Score II, we further classified these scores range into 4 different groups: 17 < SS > 17, 20 < SS > 20, 22 < SS > 22, and 26 < SS > 26 appropriately. Results of this analysis showed that the risk of mortality in patients with a high SYNTAX Score II (SS > 17) was significantly higher (RR: 2.65, 95% CI: 1.05-6.73; P = .04) than patients with a low SYNTAX Score II (SS < 17). Even when participants with a low SYNTAX Score II (SS < 20) were compared with patients who were assigned to a higher SYNTAX Score II (SS > 20), a significantly higher risk of mortality was associated with a high SYNTAX Score II (RR: 3.73, 95% CI: 1.99 - 6.96; P = .0001).
Following PCI, the risk of mortality was higher in those patients with a high SYNTAX Score II. The SYNTAX Score II might be considered as an important tool to predict mortality in Interventional Cardiology. Future research should further explore the benefits of this tool.
由于SYNTAX评分存在局限性，应由另一种更好的血管造影工具取而代之。通过比较接受低SYNTAX评分与高SYNTAX评分的患者在经皮冠状动脉介入治疗（PCI）后的死亡率，我们旨在系统地研究在介入心脏病学中使用SYNTAX评分II预测死亡率的情况。
使用“SYNTAX评分II和经皮冠状动脉介入治疗”等术语在电子数据库中搜索相关出版物。主要结局是全因死亡率。此分析由RevMan 5.3软件进行[计算风险比（RRs）和95%置信区间（95% CIs）]。
共有9443名参与者纳入本分析。由于不同研究报告的SYNTAX评分II范围不同，我们进一步将这些评分范围适当地分为4个不同组：17＜SS≤17、20＜SS≤20、22＜SS≤22和26＜SS≤26。该分析结果显示，SYNTAX评分II高（SS＞17）的患者的死亡风险显著高于SYNTAX评分II低（SS＜17）的患者（RR：2.65，95% CI：1.05 - 6.73；P = 0.04）。即使将SYNTAX评分II低（SS＜20）的参与者与SYNTAX评分II高（SS＞20）的患者进行比较，SYNTAX评分II高也与显著更高的死亡风险相关（RR：3.73，95% CI：1.99 - 6.96；P = 0.0001）。
PCI后，SYNTAX评分II高的患者死亡风险更高。SYNTAX评分II可被视为介入心脏病学中预测死亡率的重要工具。未来研究应进一步探索该工具的益处。
