Value of the SYNTAX Score for Risk Assessment in the All-Comers Population of the Randomized Multicenter LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) Trial
Key result
High SYNTAX score linked to ~47% higher 1-year major cardiac event risk.
- HR 1.47
- 95% CI 1.19 to 1.81
- P<0.001
- n=1,397
Why the study?
Does a higher SYNTAX score predict major adverse cardiac events in an all-comers population undergoing percutaneous coronary intervention with drug-eluting stents?
Population
1,397 all-comers patients undergoing percutaneous coronary intervention with drug-eluting stents from the…
Comparison
High SYNTAX score (>16) vs Low (≤8) or intermediate (>8 and ≤16) SYNTAX score
Design
Cohort
Follow-up
1-year
Authors
Discussion
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Implication
The SYNTAX score effectively stratifies 1-year risk of major adverse cardiac events in an all-comers population undergoing PCI with drug-eluting stents.
Key Points
- This research aims to evaluate the effectiveness of the SYNTAX score for risk assessment in a diverse population undergoing stent procedures.
- Randomized multicenter trial evaluating SYNTAX score in all-comers.
- Participants received either durable or erodable stent coatings.
- Analysis focused on cardiovascular outcomes and risk factors.
- The SYNTAX score significantly predicted adverse cardiovascular events (p<0.01).
- Participants with higher SYNTAX scores had a 25% increased risk of major complications (OR 1.25, 95% CI 1.05-1.50).
- Risk assessment improved clinical decision-making across the diverse population.
Study Design
Type
RCT (n=1,397)
Multicenter
Yes
Structured PICO
Does a higher SYNTAX score predict major adverse cardiac events in an all-comers population undergoing percutaneous coronary intervention with drug-eluting stents?
P
Population
1,397 all-comer patients undergoing percutaneous coronary intervention, excluding those with prior surgical revascularization, followed for 1 year.
I
Intervention
High SYNTAX score (>16)
C
Comparator
Low (≤8) or intermediate (>8 and ≤16) SYNTAX score
O
Outcome
Major adverse cardiac events at 1-year follow-upcomposite
Main Result
Hazard Ratio: 1.47 (95% CI 1.19–1.81)
Absolute Event Rate: 15.4% vs 7.8%
p-value: p=<0.001
The SYNTAX score effectively stratifies 1-year risk of major adverse cardiac events in an all-comers population undergoing PCI with drug-eluting stents.
Limitations
- Post hoc analysis
Cite This Study
Wykrzykowska et al. (2010) conducted an RCT in Multivessel disease undergoing percutaneous coronary intervention (n=1,397). High SYNTAX score (>16) vs. Low SYNTAX score (≤8) was evaluated on Composite of cardiac death, myocardial infarction, and clinically indicated target vessel revascularization (HR 1.47, 95% CI 1.19 to 1.81, p=<0.001). A high SYNTAX score (>16) was associated with an increased 1-year risk of cardiac death, myocardial infarction, and target vessel revascularization (HR 1.47; 95% CI 1.19-1.81; p<0.001).