title: Angiographically-derived SYNTAX score and its prognostic value in dialysis patients: comparison with the Khan index.
abstract: BACKGROUND
  The aim of this study was to assess the value of the angiographically-derived Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) score in predicting mortality and major adverse cardiac events (MACEs) during a 3-year follow-up of dialysis patients undergoing a percutaneous coronary intervention or coronary artery bypass graft operation. We compared the aforementioned results with the clinical Khan index.
  
  
  METHODS
  The SYNTAX score was calculated for 87 of 110 dialysis patients after coronary angiography.
  
  
  RESULTS
  The mean SYNTAX score was 12.75 ± 14.49. During the 3-year follow-up, 58% of the patients died, and 74% had at least 1 MACE. In a Kaplan-Meier survival analysis, the risk of death and MACEs increased in parallel with the SYNTAX score. A score greater than 12.75 was strongly associated with mortality and MACE (both Ps < 0.01). In receiver operating characteristic (ROC) curve analysis, the areas under the curves (AUCs) of the SYNTAX score and Khan index were significantly higher (both Ps < 0.001) than the area of diagnostic indifference. The predictive values for death as indicated by the SYNTAX score and the Khan index, respectively, were almost identical in the ROC analysis (AUC SYNTAX score, 0.6436; AUC Khan index, 0.6475; P = 0.9532). Areas under the ROC curves of both methods according to MACE were also significantly different from those for the random model (both Ps < 0.001).
  
  
  CONCLUSIONS
  The SYNTAX score is a powerful predictor of mortality and MACEs in dialysis patients undergoing percutaneous coronary intervention or coronary artery bypass graft during a 3-year follow-up. The score provides prognostic information similar to that provided by the Khan index.
authors.affiliation: Department of Cardiology, Medical University in Bialystok, Bialystok, Poland. walkaz@poczta.fm
authors.forename: Anna
authors.initials: A
authors.lastname: Tomaszuk-Kazberuk
authors.forename: Marcin
authors.initials: M
authors.lastname: Kozuch
authors.forename: Jolanta
authors.initials: J
authors.lastname: Malyszko
authors.forename: Hanna
authors.initials: H
authors.lastname: Bachorzewska-Gajewska
authors.forename: Grazyna
authors.initials: G
authors.lastname: Kobus
authors.forename: Slawomir
authors.initials: S
authors.lastname: Dobrzycki
authors.forename: Wlodzimierz J
authors.initials: WJ
authors.lastname: Musial
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D002932:Cineangiography / Q000706:statistics & numerical data*; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000401:mortality*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D003928:Diabetic Nephropathies / Q000000981:diagnostic imaging / Q000401:mortality; D054855:Drug-Eluting Stents; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000401:mortality*; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D017239:Paclitaxel; D010530:Peritoneal Dialysis; D011044:Poland; D011237:Predictive Value of Tests; D012372:ROC Curve; D006435:Renal Dialysis; D012307:Risk Factors; D012984:Software
chemical_list: D017239:Paclitaxel