title: Role of euroSCORE II in predicting long-term outcome after percutaneous catheter intervention for coronary triple vessel disease or left main stenosis.
abstract: OBJECTIVE
  The SYNTAX score (Ssc) assessing the complexity of coronary anatomy predicts survival after percutaneous coronary intervention (PCI). We tested the hypothesis that the newly developed euroSCORE II (eSC2) can improve the prediction of outcome after complex PCI by the Ssc.
  
  
  RESULTS
  Our study comprised 1262 consecutive patients with triple vessel disease or left main stenosis, who were contacted 3 years after elective PCI with drug-eluting stents. We calculated eSC2, Ssc, logistic euroSCORE, and ACEF score. Prediction of 3-year all-cause mortality by these scores was assessed by Cox proportional hazard models. Models were compared by the Hosmer-Lemeshow test for calibration (HL), the C-statistics (AUC) for discrimination and by net reclassification indices (NRI). eSC2 and Ssc were significant predictors of 3-year mortality (unadjusted hazard ratios [95%-confidence limits], 1.050 [1.033-1.067], 1.180 [1.146-1.215], respectively, P<0.001). The predictive value of eSC2 was improved by logarithmic transformation. Adding eSC2 to the model with Ssc improved calibration (HL 7.4 vs. 11.1) and discrimination (increase in AUC [95%-confidence limits] 0.12 [0.07 to 0.17]) and yielded a significant NRI of 0.38 (95%-confidence limits 0.28 to 0.47). The absolute difference in 3-year mortality between strata of Ssc (≤22, >22-32, >32) was smaller with eSC2<1% (1.4%, 3.4%, 9.7%, respectively), than with eSC2>1.6% (11.2%, 20.2%, 30.6%, respectively). The predictive ability of eSC2 was similar to that of the other clinical scores.
  
  
  CONCLUSIONS
  eSC2 predicts 3-year mortality after complex PCI and modifies the impact of angiographic complexity on outcome.
authors.affiliation: Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Germany.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.forename: Susanne
authors.initials: S
authors.lastname: Stampf
authors.forename: Christian
authors.initials: C
authors.lastname: Valina
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Kienzle
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Ferenc
authors.forename: Michael
authors.initials: M
authors.lastname: Gick
authors.forename: Ekanem
authors.initials: E
authors.lastname: Essang
authors.forename: Thomas
authors.initials: T
authors.lastname: Nührenberg
authors.forename: Heinz Joachim
authors.initials: HJ
authors.lastname: Büttner
authors.forename: Martin
authors.initials: M
authors.lastname: Schumacher
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000401:mortality* / Q000639:trends; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000401:mortality* / Q000639:trends; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D023921:Coronary Stenosis / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality* / Q000639:trends; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Coronary disease; EuroSCORE; Mortality; Percutaneous coronary intervention; SYNTAX score