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Application of SYNTAX score I, II and residual SYNTAX as predictors of long-term clinical outcomes after coronary artery bypass grafting

Session Poster Session 2

Speaker Gustavo Boros

Congress : ESC Congress 2019

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Cardiovascular Surgery - Coronary Arteries
  • Session type : Poster Session
  • FP Number : P1835

Authors : EB Martins (Sao Paulo,BR), W Hueb (Sao Paulo,BR), EG Lima (Sao Paulo,BR), PC Rezende (Sao Paulo,BR), CL Garzillo (Sao Paulo,BR), GF Carvalho (Sao Paulo,BR), FPC Carvalho (Sao Paulo,BR), JPP Linhares Filho (Sao Paulo,BR), DV Batista (Sao Paulo,BR), RR Silva (Sao Paulo,BR), GAB Boros (Sao Paulo,BR), DFC Azevedo (Sao Paulo,BR), CV Serrano Junior (Sao Paulo,BR), JAF Ramires (Sao Paulo,BR), R Kalil Filho (Sao Paulo,BR)

Authors:
EB Martins1 , W Hueb1 , EG Lima1 , PC Rezende1 , CL Garzillo1 , GF Carvalho1 , FPC Carvalho1 , JPP Linhares Filho1 , DV Batista1 , RR Silva1 , GAB Boros1 , DFC Azevedo1 , CV Serrano Junior1 , JAF Ramires1 , R Kalil Filho1 , 1Instituto do Coracao InCor Hospital das Clinicas Faculdade de Medicina Universidade de Sao Paulo SP - Sao Paulo - Brazil ,

Citation:

Background: The evaluation of coronary disease by SYNTAX score I (SSI) is used to grade coronary complexity. Following SSI, two other scores were developed: SYNTAX score II (SSII) and residual SYNTAX score (rSS). Nevertheless, there is still a lack of evidence about the prognostic significance of these scores among patients undergoing CABG.

Purpose: Our aim was to evaluate the relation of the SSI, SSII and rSS score with outcomes in a long-term follow-up after elective CABG.

Methods. This is a single center, registry-based study. Baseline SSI was calculated from patients undergoing CABG by interventional cardiologists. SSI results were considered as usual: < 23, 23-32 and >32. SSII and rSRR were then calculated and categorized in tertiles: <21.4, 21.4-29.4 and >29.4 for SSII and 0, 1-5 and >5 for rSS. Primary outcome was a composite of overall death, myocardial infarction, additional revascularization, or stroke (MACCE).

Results: Data were obtained from 559 patients. Median follow-up was 6 years (IQR: 4.9-9.8) and 170 events were documented. The Kaplan-Meier curves (figure 1) showed significant differences of MACCE in higher SSI, SSII and rSS (p=0.039, 0.033, <0.001 respectively). After multivariate adjustment, rSS, ejection fraction (EF) and age were found to be independent predictors of MACCE (p <0.001, 0.034 and 0.006, respectively).

Conclusion: In this sample SSI, II and residual were associated with the occurrence of events. However, just the rSS remained an independent predictor of MACCE together with age and EF.



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