Prognostic significance of residual functional SYNTAX score II in acute myocardial infarction

Figures

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  Fig 1. Study Flowchart: AMI, acute myocardial infarction; CABG, coronary artery bypass grafting; QFR, quantitative flow ratio; rFSS-II, residual functional SYNTAX score II.

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  Fig 2. The figure illustrates different models with distinct criteria for selecting vessels. The vessel below the white solid line represents the functional ischemic part of the vessel (QFR ≤ 0.80), while anatomically significant stenosis (more than 50% stenosis) is depicted in the middle segment (grey vessel) in (A). For example, according to the basic SS algorithm, the LAD vessel is divided into proximal, middle, and distal segments marked by the blue solid line and green dashed line. In Model A (a), only segments containing anatomically significant stenosis were calculated; hence, only the middle segment of the vessel (green segment) was included, while the distal segment and branch B6 were excluded due to the absence of stenosis. All functional ischemic vascular segments were selected in Model B (b), represented by the red segments. In Model C (c), the proximal vascular segment was selected due to an anatomical stenosis (albeit less than 50% stenosis) and branch B6 was selected due to functional ischemia, and the sum was depicted as the blue segment. QFR, quantitative flow ratio; LAD: left anterior descending.

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  Fig 3. The ROC curves of the three rFSS-II models (A/B/C) as the marker to predict MACE in patients after PCI. The AUCs of tree rFSS-II models (A/B/C) for predicting the occurrence of MACE in patients within 3 years after PCI were shown in the table. MACE, major adverse cardiac events; rFSS-II, residual functional SYNTAX score II; ROC, receiver operating characteristic; PCI, percutaneous coronary intervention; AUC, area under the ROC curve.

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  Fig 4. Kaplan-Meier Curves Showing Event Rates Stratified by the rFSS-II Through 3 Years. The groups were stratified by the optimal cutoff value of the rFSS-II determined by receiver operating characteristic curve analysis. (A) MACE, major adverse cardiac events. (B) All-cause mortality. (C) MI, myocardial infarction. (D) Any ischemia-driven revascularization.

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  Fig 5. ROC curve analysis of the rFSS-II for adverse outcomes. The AUC of the rFSS-II for predicting the occurrence of adverse outcomes in patients within 3 years after PCI were shown in the table. For all-cause mortality, the p values obtained via DeLong’s test of rFSS-II compared with rSS, rFSS and rSS-II were 0.002, 0.007 and 0.280, respectively. For other outcomes, the P-values obtained by DeLong’s test for rFSS-II and other scores exceeded 0.05.