SYNTAX Score and the Risk of Stent Thrombosis After Percutaneous Coronary Intervention in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes: An ACUITY Trial Substudy

SYNTAX Score and the Risk of Stent Thrombosis After Percutaneous Coronary Intervention in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes: An ACUITY Trial Substudy

Author Yadav, Mayank Google Scholar
Genereux, Philippe Google Scholar
Palmerini, Tullio Google Scholar
Caixeta, Adriano Autor UNIFESP Google Scholar
Madhavan, Mahesh V. Google Scholar
Xu, Ke Google Scholar
Brener, Sorin J. Google Scholar
Mehran, Roxana Google Scholar
Stone, Gregg W. Google Scholar
Institution Cardiovasc Res Fdn
Columbia Univ
Univ Montreal
Univ Bologna
Universidade Federal de São Paulo (UNIFESP)
New York Methodist Hosp
Mt Sinai Med Ctr
Abstract ObjectiveWe sought to investigate the relationship between the SYNTAX score (SS) and stent thrombosis (ST) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI).BackgroundThe relationship between the SS and ST is undetermined.MethodsWe stratified 2,627 patients undergoing PCI in the ACUITY trial by SS tertile according to the current population (true tertiles, SS <7, SS = 7-12, and SS >12) and by the SYNTAX trial (original SYNTAX tertiles, SS <23, SS = 23-32, and SS >32). Thirty-day and 1-year rates of definite/probable ST were determined for each tertile.ResultsA total 30 (1.1%) and 41 (1.6%) definite/probable ST events occurred by 30 days and 1 year, respectively. When stratified by true tertiles, 30-day and 1-year rates of definite/probable ST were significantly greater in the highest tertile (SS >12; 2.0% and 2.8%) compared with the intermediate (SS = 7-12; 0.7% and 1.1%) and lowest tertiles (SS <7; 0.6% and 0.7%), P = 0.007 and P = 0.0009, respectively. When stratified by original SYNTAX tertiles, 30-day and 1-year rates of definite/probable ST were significantly greater in the highest (SS >32; 6.3% and 8.8%) and intermediate tertiles (SS = 23-32; 2.8% and 3.7%) compared with the lowest tertile (SS < 22; 0.8% and 1.2%), P <0.0001 for both. By multivariable analysis, the SS was an independent predictor for both 30-day and 1-year definite/probable ST.ConclusionsIn patients with NSTE-ACS undergoing PCI, the extent and severity of CAD, as assessed by the SS before revascularization, was strongly associated with the occurrence of ST both at 30 days and 1 year. (c) 2014 Wiley Periodicals, Inc.
Keywords SYNTAX score
stent thrombosis
ACS
NSTE-ACS
NSTEMI
Language English
Sponsor Abbott Vascular
Doris Duke Charitable Foundation to Columbia University
Date 2015-01-01
Published in Catheterization and Cardiovascular Interventions. Hoboken: Wiley-Blackwell, v. 85, n. 1, p. 1-10, 2015.
ISSN 1522-1946 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 1-10
Origin http://dx.doi.org/10.1002/ccd.25396
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000346479900007
URI http://repositorio.unifesp.br/handle/11600/38565

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