title: The impact of SYNTAX score of non-infarct-related artery on long- term outcome among patients with acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: OBJECTIVE
  We investigated the impact of the severity of stenosis in a non-infarct-related artery (IRA) on the long-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Three hundred one consecutive patients (age: 59.7 ± 13.2 years, 85.5% men) underwent primary PCI during 2009-2012. Receiver operating characteristic curve analysis found the optimal cutoff for non-IRA SYNTAX score (SS) to be 2.5. We divided the patients into two groups according to this cutoff value.
  
  
  RESULTS
  By multivariable analysis, non-IRA SS (≥ 2.5) was an independent predictor of major adverse cardiac events (hazard ratio [HR]: 2.15, 95% confidence interval [CI]: 1.21-3.79, P  =  0.008) and all-cause mortality (HR: 3.49, 95% CI: 1.13-10.8, P  =  0.03). However, the prediction of cardiovascular mortality had only borderline significance (HR: 3.29, 95% CI: 0.90-12.08, P  =  0.07).
  
  
  CONCLUSIONS
  STEMI patients treated with primary PCI and moderate to severe non-IRA stenosis (SS ≥ 2.5) have more subsequent cardiac events. Those populations should be treated with more aggressive preventive and medical management.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Min-I
authors.initials: MI
authors.lastname: Su
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Cheng-Ting
authors.initials: CT
authors.lastname: Tsai
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan.
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan.
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012720:Severity of Illness Index