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The anatomical SYNTAX score is a scoring system based on the complexity and severity of coronary lesions and is thought to be a prognostic tool to predict long-term outcomes. One of the major limitations of using the SYNTAX score in clinical practice was SYNTAX score don’t contain the clinical characteristics. There are few researches about the prognostic value of clinical SYNTAX score in patients with acute coronary syndrome after percutaneous coronary intervention. This prospective, single-central, observational study evaluated the prognostic value of clinical SYNTAX score on 2-year outcomes in patients with acute coronary syndrome after percutaneous coronary intervention.
Between January 2013 and December 2013, 6,099 consecutive acute coronary syndrome patients admitted to Fuwai hospital and underwent PCI were enrolled in this study. Accordingly with clinical syntax score, patients were divided in low CSS group (CSS≤6.5, 2,012 patients), mid CSS group (6.5＜CSS＜13.8, 2,056 patients) and high CSS group (CSS≥13.8, 2031 patients).
At 2-years follow-up, rates of cardiac death and MACCE were significantly higher in the high CSS group. CSS was superior to the baseline SS in predicting 2-years cardiac death (AUC 0.738 vs 0.615, P<0.001), but wasn’t superior in predicting 2-years MACE (AUC 0.597 vs 0.592, P=0.285). On Cox regression analysis, CSS (p=0.000), PCI history (p =0.002), and hypertension (p<0.000) were independent predictors of cardiac death. CSS (p=0.000), IABP support (p=0.000), diabetes mellitus (p=0.004), and successful PCI (p=0.000) were independent predictors of MACE.
Clinical SYNTAX score was a good prognostic tool of long-term outcomes in ACS patients undergoing PCI combing the SYNTAX score with several clinical risk characteristics including age, ejection fraction, and creatinine clearance.