title: Prediction of 1-year clinical outcomes using the SYNTAX score in patients with prior heart failure undergoing percutaneous coronary intervention: sub-analysis of the SHINANO registry.
abstract: Although coronary artery disease (CAD) is common in patients with heart failure (HF), little is known about the prognostic significance of coronary lesion complexity in patients with prior HF undergoing percutaneous coronary intervention (PCI). The aim of this study was to investigate whether the coronary Synergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) score could improve risk stratification in HF patients with CAD. Two hundred patients (mean age 73 ± 11 years, left ventricular ejection fraction 49 ± 15 %) with prior HF who underwent PCI were divided into two groups stratified by SYNTAX score (median value 12) and tracked prospectively for 1 year. The study endpoint was the composite of major adverse cardiovascular events (MACE), including all-cause death, myocardial infarction, stroke, and hospitalization for worsening HF. Adverse events were observed in 39 patients (19.5 %). Patients with high SYNTAX scores (n = 100) showed worse prognoses than those with low scores (n = 100) (26.0 vs. 13.0 %, respectively, P = 0.021). In multivariate Cox-regression analysis, SYNTAX score ≥12 was significantly associated with MACE (hazard ratio: 1.99, 95 % confidence interval: 1.02-3.97; P = 0.045). In patients with prior HF and CAD, high SYNTAX scores predicted a high incidence of MACE. These results suggest that the SYNTAX score might be a useful parameter for improving risk stratification in these patients.
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan. masa1981@shinshu-u.ac.jp.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Minamisawa
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miura
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Motoki
authors.affiliation: Department of Cardiology, Shinshu Ueda Medical Center, Ueda, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Cardiology, Matsumoto Kyoritsu Hospital, Matsumoto, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Cardiology, Saku Central Hospital, Saku, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Cardiology, Iida Municipal Hospital, Iida, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akanuma
authors.affiliation: Department of Cardiology, Kita Alps Medical Center, Azumino, Japan.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Mawatari
authors.affiliation: Department of Cardiology, Shinonoi General Hospital, Nagano, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Cardiology, Ina Central Hospital, Ina, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Hotta
authors.affiliation: Department of Cardiology, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kamiyoshi
authors.affiliation: Department of Cardiology, Shinonoi General Hospital, Nagano, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Maruyama
authors.affiliation: Department of Cardiology, Hokushin General Hospital, Nakano, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Komoro Kosei General Hospital, Komoro, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Eisawa
authors.affiliation: Department of Cardiology, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aso
authors.affiliation: Department of Cardiology, Azumino Red Cross Hospital, Azumino, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Uchikawa
authors.affiliation: Department of Cardiology, Okaya Municipal Hospital, Okaya, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Senda
authors.affiliation: Department of Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Hashizume
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ebisawa
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Izawa
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miyashita
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Koyama
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University School of Medicine, -1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Uichi
authors.initials: U
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D016896:Treatment Outcome
keywords: Coronary artery disease; Heart failure; Prognosis; SYNTAX score