Key result
A high SYNTAX score II (>34) in STEMI patients undergoing primary PCI was associated with higher rates of MACE compared to low scores (43.2% vs 12.3%, p=0.001) over a median 2.35 years.
Why the study?
The study aimed to evaluate the prognostic impact of the SYNTAX score II in STEMI patients undergoing primary PCI.
Does the SYNTAX score II predict adverse outcomes in patients with STEMI undergoing primary PCI?
Cohort (n=1,689)
Does the SYNTAX score II predict adverse outcomes in patients with STEMI undergoing primary PCI?
Absolute Event Rate: 43.2% vs 12.3%
p-value: p=0.001
The SYNTAX score II is a powerful independent predictor of midterm MACE, heart failure, and all-cause mortality in STEMI patients undergoing primary PCI, offering additive prognostic value over GRACE and anatomical SYNTAX scores.
AIMS: This study aimed to investigate the prognostic impact of the SYNTAX score II (SS-II) on ST-segment elevation myocardial infarction (STEMI) patients undergoing a primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: This retrospective cohort study included 1,689 patients with STEMI who underwent pPCI between January 2008 and December 2016. The patients were categorised into three groups based on SS-II tertiles (SS-II low tertile <24 [n=585], SS-II intermediate tertile ≥24 and ≤34 [n=567], and SS-II high tertile >34 [n=537]). In-hospital mortality was significantly lower in patients with low and mid SS-II when compared with high SS-II (0.7% vs 0.5% vs 16.4%, p=0.001). During follow-up (median 2.35 years), a high SS-II was positively correlated with MACE (12.3% for low SS-II vs 18.3% for mid SS-II vs 43.2% for high SS-II, p=0.001), all-cause mortality (1.5% vs 3.9% vs 14.2%, p=0.001) and heart failure (0.3% vs 2.7% vs 8.2%, p=0.001). The SS-II showed additive value on top of GRACE, anatomical SYNTAX score and residual SYNTAX score. CONCLUSIONS: The SS-II in patients with STEMI undergoing pPCI adds important prognostic information regarding midterm adverse outcomes, being an independent and powerful predictor of MACE, heart failure and all-cause mortality during follow-up.
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Álvarez et al. (2019) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,689). High SYNTAX score II (>34) vs. Low (<24) and intermediate (≥24 and ≤34) SYNTAX score II was evaluated on Major adverse cardiovascular events (MACE) (p=0.001). A high SYNTAX score II (>34) in STEMI patients undergoing primary PCI was associated with higher rates of MACE compared to low scores (43.2% vs 12.3%, p=0.001) over a median 2.35 years.
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