Abramik Joanna, Kontogiannis Nestoras, Scarsini Roberto, De Maria Giovanni Luigi, Raina Tushar, Fragakis Nikolaos, Kassimis George
Department of Cardiology, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.
Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
J Geriatr Cardiol. 2023 Jul 28;20(7):509-515. doi: 10.26599/1671-5411.2023.07.003.
To verify whether incomplete revascularisation (IR), quantified using the rSYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score and ΔSYNTAX% score, could predict short- (in-hospital mortality) and long-term outcomes (12-month mortality) in octogenarians undergoing percutaneous coronary intervention (PCI).
METHODS & RESULTS: A retrospective analysis of 665 consecutive octogenarian patients presenting for PCI to a UK centre was performed. The baseline SYNTAX and rSYNTAX scores were assessed from angiographic images. ΔSYNTAX% score was calculated (ΔSYNTAX% = ((SYNTAX - rSYNTAX)/SYNTAX) × 100%)) to measure the relative completeness of revascularisation. Kaplan-Meier analysis assessed survival at 12 months by tertiles of rSYNTAX and ΔSYNTAX% scores. Increasing ΔSYNTAX% score was associated with reduced in-hospital mortality ( = 0.017), and improved survival benefit (log rank 14.8, = 0.001) at 12 months.
Enhancing the completeness of revascularisation in octogenarians selected to undergo PCI is associated with a lower in-hospital mortality and a survival benefit at 12 months.
使用rSYNTAX（紫杉醇药物洗脱支架冠状动脉介入治疗与心脏外科手术协同作用）评分和ΔSYNTAX%评分来量化不完全血运重建（IR），验证其能否预测接受经皮冠状动脉介入治疗（PCI）的八旬老人的短期（住院死亡率）和长期结局（12个月死亡率）。
对英国一家中心连续665例接受PCI的八旬老人进行回顾性分析。从血管造影图像评估基线SYNTAX和rSYNTAX评分。计算ΔSYNTAX%评分（ΔSYNTAX% = [（SYNTAX - rSYNTAX）/SYNTAX]×100%）以衡量血运重建的相对完整性。采用Kaplan-Meier分析按rSYNTAX和ΔSYNTAX%评分三分位数评估12个月生存率。ΔSYNTAX%评分增加与住院死亡率降低相关（P = 0.017），且在12个月时有更好的生存获益（对数秩检验14.8，P = 0.001）。
提高接受PCI的八旬老人的血运重建完整性与较低的住院死亡率及12个月的生存获益相关。
