Prognostic Value of Anatomical SYNTAX Score and SYNTAX Score II in Veterans With Left Main and/or Three-Vessel Coronary Artery Disease

Anatomical SYNTAX score (SS1) and SYNTAX score II (SS2) are often utilized to determine the optimal revascularization strategy. Although US veterans have unique characteristics that may affect outcomes after revascularization, the prognostic values of SS1 and SS2 in veterans have not yet been valida...

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Bibliographic Details
Published in:The American journal of cardiology 2018-07, Vol.122 (2), p.213-219
Main Authors: Misumida, Naoki, Ahmed, Ahmed Elsharawy, Barlow, Mariah, Goodwin, Rachel, Goodwin, Elliot, Musa, Ameer, Mathbout, Mohammad, Ogunbayo, Gbolahan, Kim, Sun Moon, Abdel-Latif, Ahmed, Ziada, Khaled M.
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Aged
Cardiovascular disease
Cause of Death - trends
Chronic obstructive pulmonary disease
Coronary Angiography - methods
Coronary artery
Coronary Artery Bypass - methods
Coronary artery disease
Coronary Artery Disease - diagnosis
Coronary Artery Disease - mortality
Coronary Artery Disease - surgery
Coronary vessels
Coronary Vessels - diagnostic imaging
Demographics
Diabetes
Female
Follow-Up Studies
Heart diseases
Heart surgery
Humans
Kentucky - epidemiology
Laboratories
Male
Medical prognosis
Mortality
Patients
Percutaneous Coronary Intervention - methods
Population
Prognosis
Retrospective Studies
Severity of Illness Index
Survival analysis
Survival Rate - trends
Syntax
Time Factors
Treatment Outcome
Variables
Veterans
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Summary:Anatomical SYNTAX score (SS1) and SYNTAX score II (SS2) are often utilized to determine the optimal revascularization strategy. Although US veterans have unique characteristics that may affect outcomes after revascularization, the prognostic values of SS1 and SS2 in veterans have not yet been validated. We performed a retrospective analysis of consecutive veteran patients who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main and/or 3-vessel disease from 2009 to 2014. SS1 and SS2 were calculated for each patient. The primary outcome was all-cause mortality. The prognostic values of SS1 and SS2 were compared by receiver operating characteristic curve analysis. The predicted 4-year mortality derived from SS2 was compared with the observed 4-year mortality estimated from Kaplan-Meier analysis. After exclusion, 286 patients (99% male) were included. Among 286 patients, 79 patients (27.6%) had left main disease, 151 (52.8%) underwent PCI, and 135 (47.2%) underwent CABG. Overall mortality was 27.6% at a median follow-up of 5.0 years. SS2 had better discriminative ability for all-cause mortality than SS1 (c-index 0.79 vs 0.52, p 
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2018.04.010