Author + information
- Birgit Vogel1,
- Usman Baber2,
- Samantha Sartori1,
- Jaya Chandrasekhar1,
- Serdar Farhan1,
- Sabato Sorrentino1,
- Jason Kovacic3,
- Nitin Barman4,
- Zhen Ge1,
- Srushti Shah3,
- Pooja Vijay1,
- Joseph Sweeny5,
- Pedro Moreno3,
- George Dangas3,
- Roxana Mehran2,
- Annapoorna Kini6 and
- Samin Sharma6
- 1Icahn School of Medicine at Mount Sinai, New York, New York, United States
- 2Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital, New York, New York, United States
- 3Mount Sinai Medical Center, New York, New York, United States
- 4Mt. Sinai Hospital, New York, New York, United States
- 5Mount Sinai Hospital, New York, New York, United States
- 6Mount Sinai Health System, New York, New York, United States
The SYNTAX score reflects the complexity of coronary artery disease (CAD) and a percutaneous versus surgical approach may be considered in patients with low to intermediate scores. The extent to which diabetes mellitus (DM) and chronic kidney disease (CKD), alone and in combination, influences risk according to SYNTAX score remains unclear.
We analyzed 16,885 consecutive patients with CAD undergoing PCI enrolled in a single center PCI registry between January 2010 and May 2016. Patients were stratified according to absence or presence of DM and CKD, respectively, and categorized according to SYNTAX score (low: 0-12, intermediate: 13-22, and high: ≥23). Endpoint of interest was major adverse cardiovascular events (MACE) defined as the composite of death, myocardial infarction (MI) and target vessel revascularization (TVR) at 1-year.
The proportion of patients having isolated DM, isolated CKD, and both DM and CKD were similar across SYNTAX score categories (Figure). Within all SYNTAX score categories, MACE rates were highest with both DM and CKD, while risks were comparable among patients with CKD or DM in isolation (14.9% vs. 9.3% vs. 9.9% within low, 17.0% vs. 10.6% vs. 14.8% within intermediate, and 30.4% vs. 17.0% vs. 20.7% within high SYNTAX score). The patterns of risk were unchanged after multivariate adjustment (Figure).
The combined presence of DM and CKD confers a synergistic effect on risk for MACE after PCI, even amongst patients with low SYNTAX score.
CORONARY: PCI Outcomes