Терапевтический архив (Sep 2012)
Prognostic value of SYNTAX score for outcomes and revascularization strategy choice in ST-segment elevation myocardial infarction patients with multivessel coronary artery disease
Abstract
Aim. To study the prognostic significance of the SYNTAX score in the evaluation of outcomes of primary percutaneous coronary interventions (PCIs) and revascularization strategy choice in patients with ST-elevation myocardial infarction (STEMI) with multivessel coronary artery disease. Material and methods. The long-term outcomes of primary PCIs were analyzed in 163 patients with STEMI in terms of the objective assessment of the severity of the coronary bed lesion according to SYNTAX scores. Results. In a cohort of STEMI patients who had undergone primary PCI, the SYNTAX score of ≥23 (a severe lesion) was associated with the higher incidence of acute heart failure (Killip class II) and three-vessel coronary artery disease (odds ratio (OR) 2.8), with the higher risk of death (OR 7.5) and the higher rate of the combined endpoint of death, myocardial infarction, and target vessel revascularization (OR 2.8) as compared with patients with a SYNTAX score of ≤ 22 (a moderate lesion). Conclusion. The SYNTAX score has a prognostic value in assessing the outcomes of primary PCIs in the cohort of STEMI patients with multivessel disease, which can find use in the differential choice of the optimal revascularization strategy and improve treatment results. In the group of patients with a SYNTAX score of ≥ 23, the incomplete revascularization strategy shows the least favorable results as compared to multivessel stenting and staged revascularization.
