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SYNTAX score based on coronary computed tomography angiography may have a prognostic value in patients with complex coronary artery disease: An observational study from a retrospective cohort.

Authors
 Young Joo Suh  ;  Kyunghwa Han  ;  Suyon Chang  ;  Jin Young Kim  ;  Dong Jin Im  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Jin Hur  ;  Young Jin Kim  ;  Byoung Wook Choi 
Citation
 Medicine, Vol.96(37) : e7999, 2017 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2017
MeSH
Aged ; Cerebrovascular Disorders/epidemiology ; Combined Modality Therapy ; Computed Tomography Angiography ; Coronary Angiography*/methods ; Coronary Artery Bypass ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/therapy ; Drug-Eluting Stents ; Female ; Heart Diseases/epidemiology ; Humans ; Male ; Paclitaxel/administration & dosage ; Percutaneous Coronary Intervention ; Postoperative Complications/epidemiology ; Predictive Value of Tests ; Prognosis ; Retrospective Studies
Abstract
The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score is an invasive coronary angiography (ICA)-based score for quantifying the complexity of coronary artery disease (CAD). Although the SYNTAX score was originally developed based on ICA, recent publications have reported that coronary computed tomography angiography (CCTA) is a feasible modality for the estimation of the SYNTAX score.The aim of our study was to investigate the prognostic value of the SYNTAX score, based on CCTA for the prediction of major adverse cardiac and cerebrovascular events (MACCEs) in patients with complex CAD.The current study was approved by the institutional review board of our institution, and informed consent was waived for this retrospective cohort study. We included 251 patients (173 men, mean age 66.0 ± 9.29 years) who had complex CAD [3-vessel disease or left main (LM) disease] on CCTA. SYNTAX score was obtained on the basis of CCTA. Follow-up clinical outcome data regarding composite MACCEs were also obtained. Cox proportional hazards models were developed to predict the risk of MACCEs based on clinical variables, treatment, and computed tomography (CT)-SYNTAX scores.During the median follow-up period of 1517 days, there were 48 MACCEs. Univariate Cox hazards models demonstrated that MACCEs were associated with advanced age, low body mass index (BMI), and dyslipidemia (P < .2). In patients with LM disease, MACCEs were associated with a higher SYNTAX score. In patients with CT-SYNTAX score ≥23, patients who underwent coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention had significantly lower hazard ratios than patients who were treated with medication alone. In multivariate Cox hazards model, advanced age, low BMI, and higher SYNTAX score showed an increased hazard ratio for MACCE, while treatment with CABG showed a lower hazard ratio (P < .2).On the basis of our results, CT-SYNTAX score can be a useful method for noninvasively predicting MACCEs in patients with complex CAD, especially in patients with LM disease.
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DOI
10.1097/MD.0000000000007999
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
김진영(Kim, Jin Young)
서영주(Suh, Young Joo) ORCID logo https://orcid.org/0000-0002-2078-5832
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
임동진(Im, Dong Jin) ORCID logo https://orcid.org/0000-0001-8139-5646
장수연(Chang, Su Yon)
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160779
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