title: Validation of the Ability of SYNTAX and Clinical SYNTAX Scores to Predict Adverse Cardiovascular Events After Stent Implantation: A Systematic Review and Meta-Analysis.
abstract: To compare the predicative ability of SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) and clinical SYNTAX scores for major adverse cardiac events (MACEs) after stent implantation in patients with coronary artery disease (CAD). Studies were identified by electronic and manual searches. Twenty-six studies were included in the meta-analysis. The pooled C-statistics of SYNTAX score for 1- and 5-year all-cause mortality (ACM) were 0.65 (95% confidence interval [CI]: 0.61-0.68) and 0.62 (95% CI: 0.59-0.65), respectively, with weak heterogeneity. The 1- and 5-year ACM pooled C-statistics for clinical SYNTAX scores were significantly higher at 0.77 and 0.71, respectively (Ps < .05). Both scoring systems predicted 1- and 5-year MACE equally well. The pooled risk ratio of the SYNTAX score for predicting 1-year ACM per unit was 1.04 (95% CI: 1.03-1.05). Calibration analysis indicated SYNTAX scores overestimated the risk of major adverse cardiac and cerebrovascular events in each risk stratum. The SYNTAX score demonstrated minimal discrimination in predicting 1- or 5-year adverse cardiovascular events after percutaneous coronary intervention in patients with CAD. The clinical SYNTAX score could further improve the predictive capability for ACM but not MACE.
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
authors.forename: JiaYuan
authors.initials: J
authors.lastname: Chen
authors.affiliation: Intelligent Computing Research Center, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China.
authors.forename: Buzhou
authors.initials: B
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
authors.forename: YongQing
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Ru
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
authors.forename: MaoXiong
authors.initials: M
authors.lastname: Wu
authors.affiliation: Intelligent Computing Research Center, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Intelligent Computing Research Center, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China.
authors.forename: Qingcai
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
authors.forename: YangXin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China dr_wjf@hotmail.com tjcyx1995@163.com.
authors.forename: JingFeng
authors.initials: J
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
keywords: MACE; SYNTAX score; clinical SYNTAX score; coronary artery disease; percutaneous coronary intervention; risk prediction