title: Comparison of long-term prognostic value of baseline SYNTAX and clinical SYNTAX scores in ST-segment elevation myocardial infarction patients with multivessel disease.
abstract: BACKGROUND
  The prognostic value of baseline SYNTAX (SS) and clinical SYNTAX (cSS) scores has been shown in different populations with coronary artery disease. However, their prognostic value has not been compared in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease.
  
  
  METHODS
  Patients who had undergone a primary percutaneous coronary intervention (PCI) for STEMI and had at least one critical lesion other than the culprit artery were recruited retrospectively. SS and cSS were calculated from medical records and angiograms and were compared in coronary artery by-pass grafting (CABG) and PCI groups. Long-term major adverse cardiac events (MACE) were defined as mortality, reinfarction, and target vessel revascularization.
  
  
  RESULTS
  A total of 460 patients (214 in the CABG group and 246 in the PCI group) were analyzed. The baseline SS and the cSS were significantly higher in the CABG group compared with the PCI group (30.1±6.7 vs. 22.5±5.6; P<0.01 and 41.4±21.2 vs. 27.2±15.9; P<0.01, respectively). During a follow-up period of 32±8 months, 15 patients from the CABG group and 12 patients from the PCI group died (P=0.33), but the rate of MACE was higher in the PCI group (31 vs. 20%, P<0.01). Receiver operating curve analysis and univariate Cox regression analysis indicated that SS and cSS have prognostic value in the CABG group, but not in the PCI group. In the CABG group, SS and cSS showed significant discriminative power for long-term mortality (for SS>33 sensitivity 73.3%, specificity 71.4% and for cSS>38.4 sensitivity 93.3%, specificity 58.3%) and for MACE (for SS>34.5 sensitivity 50%, specificity 81.4% and for cSS>43.5 sensitivity 66.7%, specificity 73.8%).
  
  
  CONCLUSIONS
  SS and cSS scores have prognostic value in STEMI patients with multivessel disease treated with CABG surgery. cSS may be superior to SS for prediction of long-term adverse events in CABG patients.
authors.affiliation: aDepartment of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul bDepartment of Cardiology, Erzurum Training and Research Hospital, Erzurum cDepartment of Cardiology, Necip Fazil State Hospital, Kahramanmaras, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.forename: Bariş
authors.initials: B
authors.lastname: Güngör
authors.forename: Göktürk
authors.initials: G
authors.lastname: İpek
authors.forename: Mehmet B
authors.initials: MB
authors.lastname: Karataş
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Çanga
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Akyüz
authors.forename: Recep
authors.initials: R
authors.lastname: Haci
authors.forename: Fatma Özpamuk
authors.initials: FÖ
authors.lastname: Karadeniz
authors.forename: Aylin
authors.initials: A
authors.lastname: Sungur
authors.forename: Hülya
authors.initials: H
authors.lastname: Kaşikçioğlu
authors.forename: Neşe
authors.initials: N
authors.lastname: Çam
mesh_terms: D000368:Aged; D019540:Area Under Curve; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D003661:Decision Support Techniques; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey