title: Usefulness of the SYNTAX score II to predict 1-year outcome in patients with primary percutaneous coronary intervention.
abstract: OBJECTIVE
  This study aimed to investigate the predictive effect of SYNTAX score II (SS-II) for the 1-year outcome in patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention and whether SS-II improves the ability of anatomical and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events to predict major adverse cardiac events (MACE).
  
  
  BACKGROUND
  SS-II can predict 1-year outcomes in patients with complex coronary artery disease. However, the prognostic value of SS-II for patients undergoing primary percutaneous coronary intervention remains unclear.
  
  
  METHODS
  A total of 477 patients were divided into three groups on the basis of SS-II [SS-II low tertile <20 (n=161), 20 ≤SS-II intermediate tertile ≤26 (n=145), and SS-II high tertile >26 (n=171)]. Kaplan-Meier methods were used to compare the MACE at the 1-year follow-up.
  
  
  RESULTS
  MACE was highest in the SS-II high tertile (21.1 vs. 10.3 vs. 5.5%, P<0.001), including all-cause mortality (11.7 vs. 4.1 vs. 2.5%, P=0.001), target vessel revascularization (7.6 vs. 4.1 vs. 1.8%, P=0.037), and recurrent MI (5.8 vs. 2.1 vs. 1.2%, P=0.035), compared with SS-II intermediate and low tertiles. In Cox multivariable analysis, SS-II was an independent predictor for MACE at 1 year. The receiver operating characteristic curve showed that SS-II had 60% sensitivity and 78% specificity for predicting 1-year MACE as a cut-off value of 27.5. The respective C-statistics of SS-II, anatomical, and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events for MACE were 0.726, 0.587, 0.684, and 0.628 (P<0.05).
  
  
  CONCLUSIONS
  SS-II can predict 1-year clinical outcomes in patients with ST-segment elevation myocardial infarction and has an improved ability to predict MACE.
authors.affiliation: Departments of aCardiology bCardiac Surgery, Cangzhou Central Hospital, Hebei Medical University cDepartment of Clinical Laboratory, Cangzhou People's Hospital, Canghou City, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Zhang
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.forename: Chenguang
authors.initials: C
authors.lastname: Ran
authors.forename: Lei
authors.initials: L
authors.lastname: Zhao
authors.forename: Lixian
authors.initials: L
authors.lastname: Han
mesh_terms: D000368:Aged; D019540:Area Under Curve; D016009:Chi-Square Distribution; D002681:China; D017023:Coronary Angiography; D003661:Decision Support Techniques; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / 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*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome