SYNTAX score II as a predictor of incomplete ST-segment resolution in patients with acute myocardial infarction treated with primary percutaneous intervention

Background Incomplete ST-segment resolution (STR) is a marker of impaired myocardial perfusion and adverse clinical outcome after primary percutaneous coronary intervention (PPCI). Synergy between percutaneous coronary intervention with TAXUS and cardiac surgery score II (SS-II) has been developed combining anatomical and clinical variables. The aim of the present study was to evaluate the SS-II as a predictor of incomplete STR in patients with ST-segment elevation myocardial infarction (STEMI) treated with PPCI.Patients and methods The present study prospectively included 100 patients with STEMI treated with PPCI. SS-II was determined in all patients. The sum of ST-segment elevation was measured from standard 12-lead ECG obtained on admission and from a second ECG recorded 60 min after PPCI. STR resolution was defined as either complete (≥50%) or incomplete (<50%). Patients were divided into two groups according to STR: patients with complete STR (positive STR) were 76 in number (76%) and patients with incomplete STR (negative STR) were 24 in number (24%).Results Patients in the negative STR group were older, had higher prevalence of peripheral vascular disease, lower creatinine clearance (CrCl), higher peak troponin, lower ejection fraction and a higher SS-II (P value = <0.001, 0.018, <0.001, <0.001, <0.001 and <0.001 respectively). Patients in the negative STR group also had a longer time to reperfusion (P=0.016) and higher prevalence of myocardial blush grade 0/1 (P=0.016 and <0.001, respectively). On multivariable logistic regression analysis, SS-II was an independent predictor of incomplete STR (odds ratio=0.224, 95% confidence interval, 0.209–0.778, P=0.001). Receiver-operating characteristic curve analysis identified SS-II greater than 25 as the best cutoff value predictive for incomplete STR with a sensitivity of 79.2%, specificity of 73.9%, and area under receiver-operating characteristic curve of 79.2.Conclusion SS-II is an independent predictor of incomplete STR in patients with STEMI treated with PPCI.