Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiovascular Intervention
Usefulness of the SYNTAX and Clinical SYNTAX Scores in Predicting Clinical Outcome After Unrestricted Use of Sirolimus- and Everolimus-Eluting Stents
Kyung Woo ParkJeehoon KangSi-Hyuck KangHyo-Suk AhnHae-Young LeeHyun-Jae KangBon-Kwon KooIn-Ho ChaeTae-Jin YounByung-Hee OhYoung-Bae ParkDavid E. KandzariHyo-Soo Kim
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Supplementary material

2013 Volume 77 Issue 12 Pages 2912-2921

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Abstract

Background: The SYNTAX score (SS) and clinical SS (cSS) can assess coronary lesion complexity and are useful indices in predicting outcomes after percutaneous coronary intervention. However, their validity has not been fully investigated in daily practice where “limus”-eluting stents are used. Methods and Results: The SS and cSS were independently assessed from the Efficacy of Xience/Promus vs. Cypher in rEducing Late Loss after stENTing (EXCELLENT) registry, together with the 1-year patient-oriented composite endpoint (POCE; all-cause death, any myocardial infarction (MI), and any revascularization) and target-lesion failure (TLF; cardiac death, target-vessel MI, and target-lesion revascularization). Among 5,102 patients, tertiles for SS were defined as low-SS <8, 8≤mid-SS≤16, high-SS >16. Both POCE (4.2% vs. 7.7% vs. 12.2%, P<0.001) and TLF (1.6% vs. 2.4% vs. 4.5%, P<0.001) increased significantly with increasing SS tertile, and SS was an independent predictor of POCE (P<0.001 for trend) and TLF (P=0.023 for trend) in multivariate analysis. The predictability of SS and cSS was similar for POCE (area under the curve (AUC): 0.635 vs. 0.629, P=0.599), whereas SS was superior in predicting restenosis-related outcomes such as revascularization (AUC: 0.624 vs. 0.577, P<0.001) and cSS was superior in other components such as death (AUC: 0.654 vs. 0.795, P<0.001). Conclusions: Both SS and cSS were applicable to unrestricted use of “limus”-eluting stents in predicting the risk of 1-year clinical outcomes.  (Circ J 2013; 77: 2912–2921)

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© 2013 THE JAPANESE CIRCULATION SOCIETY
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