TY - JOUR
T1 - The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: A substudy of the resolute all comers trial
AU - Garg, Scot
AU - Serruys, Patrick W.
AU - Silber, Sigmund
AU - Wykrzykowska, Joanna
AU - van Geuns, Robert Jan
AU - Richardt, Gert
AU - Buszman, Pawel E.
AU - Kelbæk, Henning
AU - van Boven, Adrianus Johannes
AU - Hofma, Sjoerd H.
AU - Linke, Axel
AU - Klauss, Volker
AU - Wijns, William
AU - MacAya, Carlos
AU - Garot, Philippe
AU - Dimario, Carlo
AU - Manoharan, Ganesh
AU - Kornowski, Ran
AU - Ischinger, Thomas
AU - Bartorelli, Antonio
AU - van Remortel, Eric
AU - Ronden, Jacintha
AU - Windecker, Stephan
PY - 2011/4
Y1 - 2011/4
N2 - Objectives: This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents. Background: The SXscore can identify patients treated with PCI who are at highest risk of adverse events. Methods: The SXscore was calculated prospectively in 2,033 of the 2,292 patients enrolled in the RESOLUTE All Comers study (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention). Clinical outcomes in terms of a patient-oriented composite endpoint (POCE) of all-cause death, myocardial infarction (MI), and repeat revascularization; the individual components of POCE; target lesion failure (TLF) (a composite of cardiac death, target-vessel MI, and clinically driven target lesion revascularization); and stent thrombosis were subsequently stratified according to SXscore tertiles: SXscoreLOW ≤9 (n = 698), 9 <SXscoreMID ≤17 (n = 676); SXscoreHIGH >17 (n = 659). Results: At 12-month follow-up, rates of POCE, MI, repeat revascularization, TLF, and the composite of death/MI were all significantly higher in patients in the highest SXscore tercile. Rates of stent thrombosis were all highest in the SXscoreHIGH tertile (p > 0.05). After multivariate adjustment, the SXscore was identified as an independent predictor of POCE, MI, repeat revascularization, and TLF (p < 0.05 for all). At 12-month follow-up, the SXscore, ACEF score, and Clinical SXscore had C-statistics of 0.57, 0.78, and 0.67, respectively, for mortality and of 0.62, 0.56, 0.63, respectively, for POCE. No significant between-stent differences were observed for TLF or POCE in any of the SXscore tertiles. Conclusions: The SYNTAX score is able to stratify risk amongst an all-comers population treated with PCI with second-generation drug-eluting stents (DES); however, improvements can be made with the inclusion of clinical variables. (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084) © 2011 American College of Cardiology Foundation.
AB - Objectives: This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents. Background: The SXscore can identify patients treated with PCI who are at highest risk of adverse events. Methods: The SXscore was calculated prospectively in 2,033 of the 2,292 patients enrolled in the RESOLUTE All Comers study (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention). Clinical outcomes in terms of a patient-oriented composite endpoint (POCE) of all-cause death, myocardial infarction (MI), and repeat revascularization; the individual components of POCE; target lesion failure (TLF) (a composite of cardiac death, target-vessel MI, and clinically driven target lesion revascularization); and stent thrombosis were subsequently stratified according to SXscore tertiles: SXscoreLOW ≤9 (n = 698), 9 <SXscoreMID ≤17 (n = 676); SXscoreHIGH >17 (n = 659). Results: At 12-month follow-up, rates of POCE, MI, repeat revascularization, TLF, and the composite of death/MI were all significantly higher in patients in the highest SXscore tercile. Rates of stent thrombosis were all highest in the SXscoreHIGH tertile (p > 0.05). After multivariate adjustment, the SXscore was identified as an independent predictor of POCE, MI, repeat revascularization, and TLF (p < 0.05 for all). At 12-month follow-up, the SXscore, ACEF score, and Clinical SXscore had C-statistics of 0.57, 0.78, and 0.67, respectively, for mortality and of 0.62, 0.56, 0.63, respectively, for POCE. No significant between-stent differences were observed for TLF or POCE in any of the SXscore tertiles. Conclusions: The SYNTAX score is able to stratify risk amongst an all-comers population treated with PCI with second-generation drug-eluting stents (DES); however, improvements can be made with the inclusion of clinical variables. (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084) © 2011 American College of Cardiology Foundation.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79955098649&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/21511223
U2 - https://doi.org/10.1016/j.jcin.2011.01.008
DO - https://doi.org/10.1016/j.jcin.2011.01.008
M3 - Article
C2 - 21511223
SN - 1936-8798
VL - 4
SP - 432
EP - 441
JO - JACC. Cardiovascular interventions
JF - JACC. Cardiovascular interventions
IS - 4
ER -