Brzozowski Piotr, Bulak Luiza, Rakotoarison Oscar, Zimoch Wojciech, Kosowski Michał, Tomasiewicz Brunon, Telichowski Artur, Reczuch Krzysztof, Kübler Piotr
Students' Scientific Group of Interventional Cardiology, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Arch Med Sci Atheroscler Dis. 2020 Dec 29;5:e313-e319. doi: 10.5114/amsad.2020.103373. eCollection 2020.
The SYNTAX Score (SS) evaluates the angiographic complexity of coronary artery disease to assess the cardiovascular risk after coronary revascularization. The aim of the study was to evaluate whether SS results are associated with in-hospital and 1-year outcomes of patients undergoing percutaneous coronary intervention (PCI) requiring rotational atherectomy (RA).
We analyzed data of 207 consecutive patients who underwent PCI with RA. Patients were divided into two groups: those with high SS (> 33 points) and those with low/intermediate SS (0-33 points).
In 21 (10%) patients SS was high and 186 (90%) patients had low/intermediate SS. Patients with high SS were older (76 vs. 71 years, = 0.008) and more frequently diagnosed with chronic kidney disease (38% vs. 18%, = 0.03) and heart failure (71% vs. 30%, = 0.0001). In patients with high SS the RA procedure was longer ( = 0.004), required more contrast ( = 0.005) and higher radiation doses ( = 0.04), and contrast-induced nephropathy was more frequent (14% vs. 2%, = 0.001).
In our RA patients there was no significant difference between the frequency of in-hospital and 1-year adverse cardiovascular events depending on the SS result. High SS correlates only with parameters describing the extensity and technical complexity of the procedure. However, the unavailability of other risk assessment tools in this population raises the need to create a new more specific risk score for patients requiring RA.
SYNTAX评分（SS）用于评估冠状动脉疾病的血管造影复杂性，以评估冠状动脉血运重建后的心血管风险。本研究的目的是评估SS结果是否与接受需要旋磨术（RA）的经皮冠状动脉介入治疗（PCI）患者的住院期间及1年预后相关。
我们分析了207例连续接受RA-PCI治疗患者的数据。患者分为两组：高SS组（>33分）和低/中SS组（0-33分）。
21例（10%）患者SS高，186例（90%）患者SS低/中。高SS患者年龄更大（76岁对71岁，P = 0.008），更常被诊断为慢性肾病（38%对18%，P = 0.03）和心力衰竭（71%对30%，P = 0.0001）。高SS患者的RA手术时间更长（P = 0.004），需要更多的造影剂（P = 0.005）和更高的辐射剂量（P = 0.04），造影剂肾病更常见（14%对2%，P = 0.001）。
在我们的RA患者中，根据SS结果，住院期间及1年不良心血管事件的发生率没有显著差异。高SS仅与描述手术范围和技术复杂性的参数相关。然而，该人群中缺乏其他风险评估工具，因此需要为需要RA的患者创建一个更具特异性的新风险评分。
