title: Comparison of the predictive value of EuroSCORE, SYNTAX score, and clinical SYNTAX score for outcomes of patients undergoing percutaneous coronary intervention for unprotected left main coronary artery disease.
abstract: OBJECTIVE
  We aimed to assess the prognostic values of the EuroSCORE, SYNTAX score, and the novel Clinical SYNTAX score (CSS) for 30-day and 1-year outcomes in patients undergoing left main (LM) percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  PCI has become an alternative treatment for LM coronary artery disease, and risk scoring system might be beneficial for pre-PCI risk stratification.
  
  
  RESULTS
  We enrolled 198 consecutive patients with unprotected LM disease undergoing PCI (mean age 71.5 ± 10.7 years). The CSS was calculated by multiplying the SYNTAX Score to (age/left ventricular ejection fraction +1 for each 10 mL the estimated glomerular filtration rate <60 mL/min per 1.73 m(2)). The endpoints were 30-day, and 1-year all-cause death and major adverse cardiovascular events (MACE), which were defined as all-cause death, nonfatal MI, and clinical-driven target vessel revascularization. Comparing with the SYNTAX score, the predictive accuracy of CSS for 30-day and 1-year all-cause death and MACE were significantly higher (c-statistics, CSS versus SYNTAX score: P < 0.01 for 30-day and 1-year all-cause death; P < 0.05 for 30-day and 1-year MACE, respectively). Furthermore, in the multivariate Cox regression analysis, both EuroSCORE and CSS were identified as the independent predictors of 30-day and 1-year all-cause death and MACE, but the SYNTAX score was not.
  
  
  CONCLUSIONS
  In the general practice among a high-risk population undergoing LM PCI, EuroSCORE and CSS might be independent predictors for 30-day and 1-year all-cause death and MACE. Furthermore, the CSS had a superior discriminatory ability in predicting the 30-day and 1-year clinical outcomes comparing with the SYNTAX score.
authors.affiliation: Division of Cardiology, Taipei City Hospital, Yang-Ming Branch, Taipei, Taiwan, Republic of China.
authors.forename: Yu-Lan
authors.initials: YL
authors.lastname: Jou
authors.forename: Tse-Min
authors.initials: TM
authors.lastname: Lu
authors.forename: Ying-Hwa
authors.initials: YH
authors.lastname: Chen
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.forename: Kang-Ling
authors.initials: KL
authors.lastname: Wang
authors.forename: Shao-Sung
authors.initials: SS
authors.lastname: Huang
authors.forename: Wan-Ting
authors.initials: WT
authors.lastname: Lin
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D023921:Coronary Stenosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome