title: Clinical implications of residual SYNTAX score after percutaneous coronary intervention in patients with chronic total occlusion and multivessel coronary artery disease: a comparison with coronary artery bypass grafting.
abstract: OBJECTIVE
  In this study we sought to evaluate the clinical impact of the residual SYNTAX score (rSS) after percutaneous coronary intervention (PCI) in patients with chronic total occlusion (CTO) and multivessel coronary artery disease (CAD).
  
  
  RESULTS
  We analysed data from 1,043 patients with CTO and multivessel CAD who were treated with PCI or coronary artery bypass grafting (CABG). Patients were divided into three groups: patients with rSS≤12 after PCI (rSS≤12 group, n=445), patients with rSS>12 after PCI (rSS>12 group, n=150), and patients who underwent CABG (CABG group, n=448). We compared the incidence of cardiac death among the three groups. During a median follow-up period of 42 months, cardiac death occurred in 14 patients (3.1%) in the rSS≤12 group, 14 patients (9.3%) in the rSS>12 group, and 29 patients (6.5%) in the CABG group. On multivariate analysis, the rSS≤12 group had a significantly lower incidence of cardiac death than the rSS>12 group (hazard ratio [HR] 0.35, 95% confidence interval [CI]: 0.16 to 0.75; p=0.01), but had an incidence of cardiac death similar to that of the CABG group (HR 0.63, 95% CI: 0.32 to 1.23; p=0.17).
  
  
  CONCLUSIONS
  An rSS≤12 after PCI may reduce the risk of cardiac mortality and could be a measure of reasonable incomplete revascularisation in patients with CTO and multivessel CAD.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jang
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Yang
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Chun
authors.forename: Ju Hyeon
authors.initials: JH
authors.lastname: Oh
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Kim
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000628:therapy*; D054059:Coronary Occlusion / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome