Author + information
- 1Department of Cardiology, Xuanwu Hospital, Capital Medical University, No.45, Changchun Street, Xicheng, Beijing, China
- 2Department of Cardiology, Cangzhou Central Hospital, Hebei Medical University, Cangzhou City, Hebei Province, China
- 3Department of Cardiac Surgery, Cangzhou Central Hospital, Hebei Medical University, Cangzhou City, Hebei Province, China
SYNTAX score can predict in-hospital major adverse cardiovascular events (MACE) in the patients admitted with ST elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI). This study aimed to assess whether the SYNTAX score II (SS-II), combined the SYNTAX score with clinical variables, can improve the ability of three different types of risk predictive scores (SYNTAX score, Global Registry of Acute Coronary Events risk score and Zwolle risk score) to predict in-hospital mortality.
The SS-II was calculated in 477 patients with STEMI who undergoing primary PCI enrolled in our study. The study population was divided into tertiles based on the SS-II values. A high SS-II (n= 196) was defined as a value in the third tertile (> 26.5), while a low SS-II (n= 322) was defined as a value in the lower two tertiles (≤ 26.5). MACE was defined as all cause mortality, advanced heart failure, target vessel revascularization (TVR), and recurrent myocardial infarction in the hospital.
MACE were significantly higher in the SS-II high group, including in-hospital mortality (5.5% vs. 0.8%, P=0.003), advanced heart failure (14.2% vs. 6.0%, P=0.002), TVR (5.7% VS. 1.2%, P=0.005), compared with those in the SS-II low group. But there was no difference in recurrent myocardial infarction (3.2% vs. 1.6%, P=0.241) between the two groups. Multivariable analysis showed SS-II was a significant independent predictor for in-hospital mortality (OR: 2.151, 95% CI:1.281-3.613, P<0.001). The receiver operating characteristic curve showed that SS-II had 93.0% sensitivity and 57.4% specificity for predicting in-hospital mortality as a cut-off value of 26.5. The respective C-statistics of SS-II, SYNTAX score, GRACE risk score and Zwolle risk score for in hospital mortality were 0.803, 0.679, 0.692, and 0.785 (P<0.05).
SS-II is a useful tool that can predict in-hospital mortality of patients with STEMI undergoing primary PCI and has an improvement ability to predict in hospital mortality.