Author + information
- He Chen,
- Jin-Qing Yuan and
- Xu Bo
Background: Left-dominant is believed to be associated with worse prognoses. The anatomical SYNTAX score(SS) is a scoring system based on the complexity and severity of coronary lesions, and is thought to be a prognostic tool to predict short and long term outcomes. SS is calculated through different segment weighing factors in different coronary dominance. There are few researches about whether the effect of Left-dominant was independent of SS. This retrospective study evaluated whether LD affected the long-term outcomes of acute coronary syndrome patients undergoing percutaneous coronary intervention, and whether the effect was independent of SYNTAX score.
Methods: Between January 2013 and December 2013, 6255 consecutive acute coronary syndrome patients admitted to Fuwai hospital and underwent PCI were enrolled in this study. Accordingly with the coronary dominance and the calculation methods of syntax score, patients were divided in left dominant group (LD group; 390 patients) and right dominant or co-dominant group (RD+Co group, 5865 patients).
Results: Patients with LD group had similar baseline to patients with RD+Co group but a higher baseline syntax score and lower rate of PCI history and hypercholesterolemia. Angiographic and procedural characteristic were similar in the 2 groups. But Patients with LD group had a higher incidences of IABP support, and a lower rate to received GP IIB/IIIA. The 2-year mortality rate was significantly higher in the LD group compared to the RD+Co group(2.58%vs.1.23%, P = 0.024). In multivariate COX analysis, the independent predictors of mortality to mortality were coronary dominance (HRs 2.421, 95% CI 1.235 to 4.739, p=0.010), IABP support (HRs 3.154, 95% CI 1.233 to 8.065, p =0.016), age (HRs 1.072, 95% CI 1.041 to 1.104, p<0.001), baseline SS (HRs1.047, 95% CI 1.047-1.091, p =0.026), EF (HRs 0.943, 95% CI 0.917 to 0.969, p =0.000).
Conclusions: LD was an independently predictor of long-term mortality in ACS patients undergoing PCI. The effect of LD still existed after adjustment for several important variables, and was independent of SYNTAX score. Age, IABP support, EF and baseline SS were also considered independent predictors of long-term mortality.
Poster Contributions Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Timely Topics in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology Presentation Number: 1242-151
- 2017 American College of Cardiology Foundation