TY - JOUR
T1 - Validation of the Coronary Artery Bypass Graft SYNTAX Score (Synergy between Percutaneous Coronary Intervention with Taxus) as a Prognostic Marker for Patients with Previous Coronary Artery Bypass Graft Surgery after Percutaneous Coronary Intervention
AU - Miyagi, Tadayoshi
AU - Asaumi, Yasuhide
AU - Nishimura, Kunihiro
AU - Nakashima, Takahiro
AU - Sakamoto, Hiroki
AU - Nakao, Kazuhiro
AU - Kanaya, Tomoaki
AU - Nagai, Toshiyuki
AU - Shimabukuro, Yuji
AU - Miyamoto, Yoshihiro
AU - Fujita, Tomoyuki
AU - Kusano, Kengo
AU - Anzai, Toshihisa
AU - Kobayashi, Junjirou
AU - Noguchi, Teruo
AU - Ogawa, Hisao
AU - Yasuda, Satoshi
N1 - Publisher Copyright:
© 2016 American Heart Association, Inc.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background-The efficacy and prognosis of percutaneous coronary intervention (PCI) as secondary revascularization in patients with previous coronary artery bypass graft surgery remain uncertain. Methods and Results-We retrospectively evaluated 434 consecutive patients with previous coronary artery bypass graft surgery hospitalized for PCI between 2004 and 2011 (men 84%, age 71 (interquartile range, 66-76) years) and calculated the coronary artery bypass graft Synergy Between Percutaneous Coronary Intervention With Taxus score (CSS) before (baseline CSS) and after PCI (post-PCI CSS). Patients were divided into 2 groups based on median post-PCI CSS: low-score (≤23; n=217) and high-score groups (>23; n=217). Major adverse cardiovascular events (MACE) were defined as the composite of cardiovascular death, myocardial infarction, and unplanned repeat revascularization for myocardial ischemia. The median baseline and post-PCI CSS were 30 (interquartile range, 21-40) and 23 (interquartile range, 14.5-33.5), respectively. During a median follow-up of 69 months, the prevalence of MACE and cardiac death differed significantly between the 2 post-PCI CSS groups (MACE: low, 13.8%; high, 28.6%; P<0.001; cardiac death: low, 6.2%; high, 16.7%; P=0.002). In multivariable analysis, the high post-PCI CSS divided by the median was associated with substantially greater cumulative MACE (hazard ratio, 2.09; 95% confidence interval, 1.31-3.34; P=0.002) and cardiac death (hazard ratio, 2.02; 95% confidence interval, 1.03-3.98; P=0.042) compared with the low post-PCI CSS. Net reclassification improvement analysis revealed that post-PCI CSS resulted in significantly improved prediction of MACE and cardiac death compared with baseline CSS. Conclusions-In this external validation study, the CSS was a potential prognostic factor after subsequent PCI, even for previous coronary artery bypass graft surgery patients.
AB - Background-The efficacy and prognosis of percutaneous coronary intervention (PCI) as secondary revascularization in patients with previous coronary artery bypass graft surgery remain uncertain. Methods and Results-We retrospectively evaluated 434 consecutive patients with previous coronary artery bypass graft surgery hospitalized for PCI between 2004 and 2011 (men 84%, age 71 (interquartile range, 66-76) years) and calculated the coronary artery bypass graft Synergy Between Percutaneous Coronary Intervention With Taxus score (CSS) before (baseline CSS) and after PCI (post-PCI CSS). Patients were divided into 2 groups based on median post-PCI CSS: low-score (≤23; n=217) and high-score groups (>23; n=217). Major adverse cardiovascular events (MACE) were defined as the composite of cardiovascular death, myocardial infarction, and unplanned repeat revascularization for myocardial ischemia. The median baseline and post-PCI CSS were 30 (interquartile range, 21-40) and 23 (interquartile range, 14.5-33.5), respectively. During a median follow-up of 69 months, the prevalence of MACE and cardiac death differed significantly between the 2 post-PCI CSS groups (MACE: low, 13.8%; high, 28.6%; P<0.001; cardiac death: low, 6.2%; high, 16.7%; P=0.002). In multivariable analysis, the high post-PCI CSS divided by the median was associated with substantially greater cumulative MACE (hazard ratio, 2.09; 95% confidence interval, 1.31-3.34; P=0.002) and cardiac death (hazard ratio, 2.02; 95% confidence interval, 1.03-3.98; P=0.042) compared with the low post-PCI CSS. Net reclassification improvement analysis revealed that post-PCI CSS resulted in significantly improved prediction of MACE and cardiac death compared with baseline CSS. Conclusions-In this external validation study, the CSS was a potential prognostic factor after subsequent PCI, even for previous coronary artery bypass graft surgery patients.
KW - Coronary artery bypass
KW - coronary artery disease
KW - myocardial revascularization
KW - percutaneous coronary intervention
KW - standard of care
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U2 - 10.1161/CIRCINTERVENTIONS.115.003459
DO - 10.1161/CIRCINTERVENTIONS.115.003459
M3 - Article
C2 - 27578838
AN - SCOPUS:84988735539
VL - 9
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
SN - 1941-7640
IS - 9
M1 - e003459
ER -