Key result
The SYNTAX II score (cutoff 29.3) showed the highest predictive value for one-year MACE in patients with acute myocardial infarction after PCI, with 88.2% sensitivity and 76.8% specificity.
Why the study?
The study aimed to determine the predictive power of a combination of GRACE, SYNTAX I, and SYNTAX II scores for MACE and one-year mortality in patients with STEMI and NSTEMI after primary PCI.
Do GRACE, SYNTAX I, and SYNTAX II scores predict one-year MACE and mortality in patients with acute myocardial infarction treated with primary PCI?
Cohort (n=400)
No
Do GRACE, SYNTAX I, and SYNTAX II scores predict one-year MACE and mortality in patients with acute myocardial infarction treated with primary PCI?
The SYNTAX II score demonstrates high sensitivity and specificity for predicting one-year major adverse cardiovascular events in patients undergoing primary PCI for acute myocardial infarction.
May aid post-PCI MACE stratification with SYNTAX II; leaves open prospective validation versus GRACE/SYNTAX I.
Background/Aim. The fundamental objective of primary percutaneous coronary intervention (PCI) in myocardial infarction is to provide early, complete, and sustained flow in the occluded artery that has led to myocardial ischemia or necrosis. The aim of this study was to determine the predictive power of a combination of GRACE, SYNTAX I, and SYNTAX II scores in predicting major adverse cardiovascular events (MACE) and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) after primary PCI. Methods. The study included 400 patients who had their first acute myocardial infarction and underwent PCI. The patients were treated and followed for one year at the Clinical Hospital Center Zvezdara at the Department of Interventional Cardiology. By monitoring the defined clinical parameters, a comparative analysis of risk scores GRACE, SYNTAX I, and SYNTAX II was performed. Their sensitivity, specificity as well as predictive possibilities in predicting adverse outcomes were determined. Results. The incidence of MACE in our sample was 12.8%. Patients with STEMI entity had significantly higher values of GRACE, SYNTAX I, and SYNTAX II scores. The highest value for predicting the occurrence of MACE was shown by the SYNTAX II score (score value 29.3), with a sensitivity of 88.2% and a specificity of 76.8%. The GRACE score was a significant predictor of SYNTAX I and SYNTAX II scores. A two-way correlation was observed between the high score values of all three scores. Conclusion. The presented scores for the assessment of clinical and angiographic indicators showed good predictive power in assessing the outcome of adverse cardiovascular events in both clinical entities of acute myocardial infarction during one-year follow-up. By using the proposed scores to assess MACE, we can single out high-risk patients in order to prevent adverse events and reduce mortality. This suggests its suitability for clinical use in this patient population.
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Davidović et al. (2021) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) (n=400). GRACE, SYNTAX I, and SYNTAX II scores was evaluated on major adverse cardiovascular events (MACE) and one-year mortality. The SYNTAX II score (cutoff 29.3) showed the highest predictive value for one-year MACE in patients with acute myocardial infarction after PCI, with 88.2% sensitivity and 76.8% specificity.
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