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

被引：203

作者：

Wykrzykowska, Joanna J. ^{[1
]}

Garg, Scot ^{[1
]}

Girasis, Chrysafios ^{[1
]}

de Vries, Ton ^{[2
]}

Morel, Marie-Angele ^{[2
]}

van Es, Gerrit-Anne ^{[2
]}

Buszman, Pawel ^{[3
]}

Linke, Axel ^{[4
]}

Ischinger, Thomas ^{[5
]}

Klauss, Volker ^{[6
]}

Corti, Roberto ^{[7
]}

Eberli, Franz ^{[7
]}

Wijns, William ^{[8
]}

Morice, Marie-Claude ^{[9
]}

di Mario, Carlo ^{[10
]}

van Geuns, Robert Jan ^{[1
]}

Juni, Peter ^{[11
]}

Windecker, Stephan ^{[12
]}

Serruys, Patrick W. ^{[1
]}

机构：

[1] Erasmus Sch Ctr, Thoraxctr, Dept Intervent Cardiol, NL-3015 CE Rotterdam, Netherlands

[2] Cardialysis BV, Rotterdam, Netherlands

[3] Med Univ Silesia, Katowice, Poland

[4] Herzzentrum Leipzig, Leipzig, Germany

[5] Hosp Bogenhausen, Dept Cardiol, Munich, Germany

[6] Univ Hosp Munich Innenstadt, Dept Cardiol, Munich, Germany

[7] Univ Hosp, Dept Cardiol, Zurich, Switzerland

[8] Onze Lieve Vrouw Hosp, Dept Cardiol, Aalst, Belgium

[9] Inst Cardiovasc, Paris, Massy, France

[10] Royal Brompton Hosp, Dept Cardiol, London SW3 6LY, England

[11] Univ Hosp Bern, CTU Bern, CH-3010 Bern, Switzerland

[12] Univ Hosp Bern, Dept Cardiol, CH-3010 Bern, Switzerland

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2010年 / 56卷 / 04期

关键词：

biodegradable polymer; biolimus-eluting stent; major adverse cardiac event; prognostic value; sirolimus-eluting stent; target vessel revascularization; SYNTAX score; PERCUTANEOUS CORONARY INTERVENTION; SIROLIMUS-ELUTING STENT; ARTERY-DISEASE; SUBGROUP ANALYSES; ANGIOPLASTY; STENOSES;

D O I：

10.1016/j.jacc.2010.03.044

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives We aimed to assess the predictive value of the SYNTAX score (SXscore) for major adverse cardiac events in the all-comers population of the LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) trial. Background The SXscore has been shown to be an effective predictor of clinical outcomes in patients with multivessel disease undergoing percutaneous coronary intervention. Methods The SXscore was prospectively collected in 1,397 of the 1,707 patients enrolled in the LEADERS trial (patients after surgical revascularization were excluded). Post hoc analysis was performed by stratifying clinical outcomes at 1-year follow-up, according to 1 of 3 SXscore tertiles. Results The 1,397 patients were divided into tertiles based on the SXscore in the following fashion: SXscore <= 8 (SXlow) (n = 464), SXscore > 8 and <= 16 (SXmid) (n = 472), and SXscore <= 16 (SXhigh) (n = 461). At 1-year follow-up, there was a significantly lower number of patients with major cardiac event-free survival in the highest tertile of SXscore (SXlow = 92.2%, SXmid = 91.1%, and SXhigh = 84.6%; p < 0.001). Death occurred in 1.5% of SXlow patients, 2.1% of SXmid patients, and 5.6% of SXhigh patients (hazard ratio [HR]: 1.97, 95% confidence interval [CI]: 1.29 to 3.01; p = 0.002). The myocardial infarction rate tended to be higher in the SXhigh group. Target vessel revascularization was 11.3% in the SXhigh group compared with 6.3% and 7.8% in the SXlow and SXmid groups, respectively (HR: 1.38, 95% CI: 1.1 to 1.75; p = 0.006). Composite of cardiac death, myocardial infarction, and clinically indicated target vessel revascularization was 7.8%, 8.9%, and 15.4% in the SXlow, SXmid, and SXhigh groups, respectively (HR: 1.47, 95% CI: 1.19 to 1.81; p < 0.001). Conclusions The SXscore, when applied to an all-comers patient population treated with drug-eluting stents, may allow prospective risk stratification of patients undergoing percutaneous coronary intervention. (LEADERS Trial Limus Eluted From A Durable Versus ERodable Stent Coating; NCT00389220). (J Am Coll Cardiol 2010; 56: 272-7) (c) 2010 by the American College of Cardiology Foundation

引用

页码：272 / 277

页数：6

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