title: Validation of residual SYNTAX score with second-generation drug-eluting stents: one-year results from the prospective multicentre SEEDS study.
abstract: OBJECTIVE
  The SYNTAX score has been proposed as a valuable tool to characterise coronary anatomy prospectively based on its complexity. This study evaluated the prognostic value on adverse outcomes of the residual SYNTAX score (rSS) in patients with complex lesions treated with an everolimus-eluting stent (EES).
  
  
  RESULTS
  One thousand eight hundred and fifty-one patients with small vessel (reference diameter <2.75 mm), long lesion (length >25 mm), or multivessel (>2 target vessels) disease who underwent percutaneous coronary intervention (PCI) with EES in the prospective SEEDS (A Registry To Evaluate Safety And Effectiveness Of Everolimus Drug Eluting Stent For Coronary Revascularization) trial were categorised into low (<6), mid (>6-<12) and high (>12) baseline SYNTAX score (bSS) groups, and into low (=0), mid (>0-<5) and high (>5) rSS groups. Mean bSS and rSS were 10.87±7.26 and 2.18±3.97, respectively; 64% of patients had complete revascularisation (rSS=0). At 12 months the primary outcome of ischaemia-driven target vessel failure (TVF, composite of cardiac death, target vessel myocardial infarction and ischaemia-driven target vessel revascularisation) was significantly higher in the high bSS and rSS groups than in the respective lower groups (p<0.01 for both). In multivariable analysis, rSS was an independent predictor of TVF (hazard ratio: 1.403, 95% confidence interval: 1.081 to 1.820, p=0.01).
  
  
  CONCLUSIONS
  Twelve-month TVF was significantly higher in the highest rSS group; rSS with a cut-off of 5 might therefore allow the risk stratification of patients with complex lesions treated with a second-generation drug-eluting stent (Clinical-Trials.gov identifier: NCT 01157455).
authors.affiliation: Fu Wai Hospital, National Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Yue-Jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Han
authors.forename: Shu-Zheng
authors.initials: SZ
authors.lastname: Lu
authors.forename: Bao
authors.initials: B
authors.lastname: Li
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
authors.forename: Guo-Ying
authors.initials: GY
authors.lastname: Zhu
authors.forename: Jun-Yu
authors.initials: JY
authors.lastname: Cui
authors.forename: Lang
authors.initials: L
authors.lastname: Li
authors.forename: Ye-Lin
authors.initials: YL
authors.lastname: Zhao
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
mesh_terms: D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus