Key result
The SYNTAX score-II was an independent predictor of in-hospital MACE, mortality, nonfatal MI, and stent thrombosis in NSTEMI patients undergoing PCI (OR 1.082; 95% CI 1.036-1.131; p<0.001).
Why the study?
Do risk scores (SS, SS-II, TIMI, GRACE) predict in-hospital MACE in patients with NSTEMI undergoing PCI?
Observational (n=589)
Do risk scores (SS, SS-II, TIMI, GRACE) predict in-hospital MACE in patients with NSTEMI undergoing PCI?
Effect estimate: OR 1.082 (95% CI 1.036-1.131)
p-value: p=<0.001
SYNTAX score-II is an independent predictor of in-hospital MACE, mortality, nonfatal MI, and stent thrombosis in NSTEMI patients undergoing PCI, alongside TIMI and GRACE scores.
SS-II may refine in-hospital risk stratification in NSTEMI PCI; leaves open prospective validation against TIMI/GRACE before adoption.
OBJECTIVE: We evaluated the relationship between various risk scores (SYNTAX score [SS], SYNTAX score-II [SS-II], thrombolysis in myocardial infarction [TIMI] risk scores, and Global Registry of Acute Coronary Events [GRACE] risk scores) and major adverse cardiovascular events (MACE) in non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: The study population were selected from among 589 patients who underwent coronary angiography with a diagnosis of NSTEMI. TIMI and GRACE risk scores were calculated. SS and SS-II were calculated in all patients, and points were added according to the predefined algorithm, taking into account the other 6 clinical variables being monitored (age, sex, left ventricular ejection fraction, creatinine clearance, chronic obstructive pulmonary disease, and peripheral artery disease). Patients were classified into tertile 1 (SS < 22), tertile 2 (SS 23-32), and tertile 3 (SS > 32). RESULTS: The group with high SS-II for PCI values in the risk scores were observed from tertile 1 to tertile 3 (from 25.0 ± 7.7 to 31.6 ± 9.4, p < 0.001, respectively). The SS-II score in patients with PCI was an independent predictor of MACE, in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis (OR 1.082, 95% CI 1.036-1.131, p < 0.001). The overall MACE, in-hospital mortality, and nonfatal myocardial infarction rates were significantly higher in the high SS-II for PCI group (p < 0.001). CONCLUSION: TIMI and GRACE risk scores were able to predict MACE. In addition to these, SS-II was also able to predict in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis.
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Aktürk et al. (2018) conducted an observational in Non-ST elevation myocardial infarction (NSTEMI) (n=589). SYNTAX score-II, SYNTAX score, TIMI, and GRACE risk scores was evaluated on MACE, in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis (OR 1.082, 95% CI 1.036-1.131, p=<0.001). The SYNTAX score-II was an independent predictor of in-hospital MACE, mortality, nonfatal MI, and stent thrombosis in NSTEMI patients undergoing PCI (OR 1.082; 95% CI 1.036-1.131; p<0.001).
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