Risk stratification of patients undergoing medical therapy after coronary angiography

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dc.citation.issue40
dc.citation.volume37
dc.contributor.authorBettinger, Nicolas
dc.contributor.authorPalmerini, Tullio
dc.contributor.authorCaixeta, Adriano [UNIFESP]
dc.contributor.authorDressler, Ovidiu
dc.contributor.authorLitherland, Claire
dc.contributor.authorFrancese, Dominic P.
dc.contributor.authorGiustino, Gennaro
dc.contributor.authorMehran, Roxana
dc.contributor.authorLeon, Martin B.
dc.contributor.authorStone, Gregg W.
dc.contributor.authorGenereux, Philippe
dc.coverageOxford
dc.date.accessioned2020-07-31T12:47:38Z
dc.date.available2020-07-31T12:47:38Z
dc.date.issued2016
dc.description.abstractAim We sought to investigate the prognostic impact of the SYNTAX (Synergy between PCI with TAXUS and Cardiac Surgery) score (SS) on 1-year clinical outcomes in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) undergoing medical therapy only. Methods and results Among the 13 819 patients enrolled in the ACUITY trial and undergoing coronary angiogram, 4491 patients were treated with medical therapy as the initial strategy. Of those, baseline SS and complete angiographic analysis were available in 1275 patients. Patients were divided in four groups based on the presence or absence of coronary artery disease (CAD) and subsequently, among patients with CAD, by SS. Major adverse cardiac events (MACE) and its individual components (death, myocardial infarction, and unplanned revascularization) were compared between groups. Among the 1275 patients, the mean SS was 3.5 +/- 7.0 (range 0-45). SYNTAX score was 0 in 842 patients, >0 and <= 5 in 170, >5 and <= 11 in 119, and >11 in 144 patients. The 1-year rates of MACE were higher in patients with CAD and higher SS. By multivariable analysis, the SS was a strong predictor of all adverse ischaemic events, including mortality. By receiver operator characteristic analysis, an SS cut-off of 8 showed the best prognostic accuracy for death and MACE. Conclusions In patients with NSTE ACS undergoing medical therapy, the SS, especially when 8, was shown to be a strong predictor of 1-year MACE, including mortality. This finding has important clinical implications for risk stratification of patients with NSTE ACS undergoing medical therapy after an initial angiogram.en
dc.description.affiliationColumbia Univ, NewYork Presbyterian Hosp, Med Ctr, New York, NY 10032 USA
dc.description.affiliationCardiovasc Res Fdn, 111 East 59th St,12th Floor, New York, NY 10019 USA
dc.description.affiliationUniv Bologna, Policlin S Orsola, Ist Cardiol, Bologna, Italy
dc.description.affiliationUniv Fed Sao Paulo, Hosp Israelita Albert Einstein, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationIcahn Sch Med Mt Sinai, New York, NY 10029 USA
dc.description.affiliationUniv Montreal, Hop Sacre Coeur Montreal, Montreal, PQ, Canada
dc.description.affiliationUnifespEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipAbbott Vascular
dc.description.sponsorshipEli Lilly
dc.description.sponsorshipAstraZeneca
dc.description.sponsorshipMedicines Company
dc.description.sponsorshipBMS/Sanofi-Aventis
dc.description.sponsorshipEdwards Lifesciences
dc.description.sponsorshipCSI
dc.format.extent3103-3110
dc.identifierhttp://dx.doi.org/10.1093/eurheartj/ehv674
dc.identifier.citationEuropean Heart Journal. Oxford, v. 37, n. 40, p. 3103-3110, 2016.
dc.identifier.doi10.1093/eurheartj/ehv674
dc.identifier.issn0195-668X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56965
dc.identifier.wosWOS:000388522900011
dc.language.isoeng
dc.publisherOxford Univ Press
dc.relation.ispartofEuropean Heart Journal
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectSYNTAX scoreen
dc.subjectNon-ST-elevation acute coronary syndromesen
dc.subjectMedical therapyen
dc.titleRisk stratification of patients undergoing medical therapy after coronary angiographyen
dc.typeinfo:eu-repo/semantics/article
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