Author + information
- Fengqiang Dang1,2,
- Lijun Wang2,
- Xianjing Wei2,
- Zezhou Xie2,
- Limei Qi1,2,
- Yumei Chen1,2 and
- Lianna Xie2
To compare the predictive value of Gensini score (GS), SYNTAX score (SS), clinical SYNTAX score (CSS) and SYNTAX score II(SS2) for long-term clinical outcome in patients with acute myocardial infarction (AMI) after PCI.
A total of 643 cases of patients with AMI who were treated with PCI in our department from January 2010 to November 2015 were studied. Patients were stratified into four groups according to each score quartiles. All patients were followed up for 1 year. The primary endpoint was major adverse cardiac events (MACE), including mortality, myocardial infarction, revascularization and heart failure. We used cox regression analysis to evaluate the independent risk factors of MACE. Furthermore, area under receiver-operating- characteristic curves (AUC) was generated to compare the predictive ability of scores.
From low to high score groups, the rates of MACE were increased gradually in every score system (all p<0.001). In GS and SS, the rates of mortality, revascularization and heart failure in high score groups were significantly higher than that of low groups. In CSS and SS2, the rates of mortality, myocardial infarction and heart failure in high score groups were significantly increased. Cox regression analysis showed that, after controlling for other confounding factors, all four scores were independent predictors of MACE in 1 year after AMI. Although the greatest AUC to predict MACE was GS (AUC=0.667), the difference between scores was no statistically significant(p>0.05). The accuracy of the prediction of mortality from high to low was SS2 (AUC=0.806), CSS (AUC=0.736), GS (AUC=0.667), SS (AUC=0.632), and SS2 was significantly better than SS (p=0.009) and GS (p=0.04). The accuracy of predicting heart failure from high to low were SS2 (AUC=0.705), CSS (AUC=0.701), GS (AUC=0.619), SS (AUC=0.615); both SS2 and CSS were better than SS and GS (all p<0.05).
All the four score systems were independent predictors of 1-year MACE and the predictability was similar. GS and SS can accurately predict revascularization, while other score systems cannot. Only CSS and SS2 can predict myocardial infarction. The accuracy of predicting mortality and heart failure was improved using CSS and SS2.