title: Predictive value of SYNTAX score in risk stratification of patients undergoing unprotected left main coronary artery angioplasty.
abstract: BACKGROUND
  The SYNTAX score is a useful tool to evaluate percutaneous coronary intervention risk regarding the number, complexity, and location of lesions. Despite its proven value in the prognosis of three-vessel disease, there are few data about its usefulness in other selected subsets of patients. This study aimed to evaluate the prognostic value of the SYNTAX score in a population of patients who underwent unprotected left main coronary artery (ULMCA) angioplasty in our hospital.
  
  
  METHODS
  This was a single-center study that included 118 patients (79.7% male; mean age, 66 ± 12 years) who underwent ULMCA angioplasty between March 1999 and December 2008. Multivariate Cox logistic regression analysis was used to assess the relation of SYNTAX score to the incidence of cardiovascular death and major adverse cardiac events (MACE) - an endpoint comprised of cardiovascular death, non-fatal acute myocardial infarction, and target vessel revascularization.
  
  
  RESULTS
  At 30 days, there were 5 cardiovascular deaths (4.2%). In the mean follow-up of 32 ± 24 months, there were 17 cardiovascular deaths (14.4%) and 30 MACE (25.4%). At 30 days, SYNTAX score had no predictive value, but at long-term follow-up, it significantly predicted the occurrence of cardiovascular death (adjusted hazard ratio, 1.069; 95% CI, 1.030-1.109; P<.0001) and MACE (adjusted hazard ratio, 1.044; 95% CI, 1.013-1.076; P=.005), even after adjustment for potential confounders. Area under the curve for the occurrence of cardiovascular death and MACE was 0.75 (P=.0006) and 0.63 (P=.032), respectively.
  
  
  CONCLUSIONS
  In this population of patients undergoing ULMCA angioplasty, SYNTAX score was demonstrated to be a valuable tool to predict long-term cardiovascular mortality.
authors.affiliation: Hospital Santa Cruz, Cardiology, Av. Prof. Dr. Reinaldo dos Santos, Carnaxide, Portugal. jdbrito@netcabo.pt
authors.forename: João
authors.initials: J
authors.lastname: Brito
authors.forename: Rui
authors.initials: R
authors.lastname: Teles
authors.forename: Manuel
authors.initials: M
authors.lastname: Almeida
authors.forename: Pedro
authors.initials: P
authors.lastname: de Araújo Gonçalves
authors.forename: Luis
authors.initials: L
authors.lastname: Raposo
authors.forename: Pedro
authors.initials: P
authors.lastname: Sousa
authors.forename: Miguel
authors.initials: M
authors.lastname: Mendes
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends