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Title: 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
Authors: Yadav, Mayank
Genereux, Philippe
Palmerini, Tullio
Caixeta, Adriano [UNIFESP]
Madhavan, Mahesh V.
Xu, Ke
Brener, Sorin J.
Mehran, Roxana
Stone, Gregg W.
Cardiovasc Res Fdn
Columbia Univ
Univ Montreal
Univ Bologna
Universidade Federal de São Paulo (UNIFESP)
New York Methodist Hosp
Mt Sinai Med Ctr
Keywords: SYNTAX score
stent thrombosis
Issue Date: 1-Jan-2015
Publisher: Wiley-Blackwell
Citation: Catheterization and Cardiovascular Interventions. Hoboken: Wiley-Blackwell, v. 85, n. 1, p. 1-10, 2015.
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.
ISSN: 1522-1946
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