title: Baseline SYNTAX score and long-term outcome in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: OBJECTIVE
  The SYNTAX score (SXscore) has emerged as a reproducible angiographic tool to quantify the extent of coronary artery disease based on the location and complexity of each lesion. The aim of this study was to evaluate whether the SXscore is an independent predictor of long-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  A total of 2993 patients with acute STEMI who underwent primary PCI were stratified into the 4 groups according to the SXscore quartiles; quartile 1(Q1, SXscore ≤ 9, n = 819), Q2 (9 < SXscore < 16, n = 715), Q3 (16 ≤ SXscore < 20, n = 710), and Q4 (SXscore ≥ 20, n = 749).
  
  
  RESULTS
  There were significant differences among the quartiles with respect to age, basal creatinine and glucose levels, and the incidences of diabetes mellitus, Killip ≥2, and anemia. From Q1 to Q4, there were increasing rates of culprit left anterior descending lesion (P < .001), multivessel disease (P < .001), chronic total occlusion (P < .001), and proximal lesion localization (P < .001). At long-term follow-up, all-cause mortality, nonfatal myocardial infarction, stroke, rehospitalization due to heart failure, and the need of revascularization were significantly more frequent among the patients in the highest SXscore quartile. In multivariate analysis, after including the SXscore as a numerical variable into the model, every point of increase was determined as an independent predictor for long-term mortality (hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.01-1.05, P = .008) and for overall major adverse cardiac events (MACEs; HR 1.02, 95% CI 1.01-1.04, P < .001).
  
  
  CONCLUSIONS
  The SXscore is an independent predictor of both in-hospital and long-term mortality and MACE in patients with acute STEMI undergoing primary PCI.
authors: Department of Cardiology, Kosuyolu Heart & Research Hospital, Istanbul, Turkey taylan_akgun@yahoo.com.
authors: Taylan
authors: T
authors: Akgun
authors: Department of Cardiology, Medical Park Fatih Hospital, Istanbul, Turkey.
authors: Vecih
authors: V
authors: Oduncu
authors: Department of Cardiology, Bahcesehir University.
authors: Atila
authors: A
authors: Bitigen
authors: Department of Cardiology, Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
authors: Can Yucel
authors: CY
authors: Karabay
authors: Department of Cardiology, Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
authors: Ayhan
authors: A
authors: Erkol
authors: Department of Cardiology, Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
authors: Gonenc
authors: G
authors: Kocabay
authors: Department of Cardiology, Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
authors: Olcay
authors: O
authors: Ozveren
authors: Department of Cardiology, Medical Park Fatih Hospital, Istanbul, Turkey.
authors: Abdulmelik
authors: A
authors: Yildiz
authors: Department of Cardiology, Medical Park Fatih Hospital, Istanbul, Turkey.
authors: Arif Oguzhan
authors: AO
authors: Cimen
authors: Department of Cardiology, Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
authors: Cevat
authors: C
authors: Kirma
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D015996:Survival Rate
chemical_list: D001786:Blood Glucose; D003404:Creatinine
keywords: SYNTAX score; acute coronary syndromes; mortality