Abstract
Background: Few studies have examined if two score systems of coronary stenosis, SYNTAX score and Gensini score, are different as predictors of prognosis in patients with coronary artery disease (CAD). Here we examined this issue in patients with stable CAD after percutaneous coronary intervention (PCI). Methods: We retrospectively analyzed 795 consecutive patients who underwent coronary angiography for suspected stable CAD from January 2007 to August 2012. One hundred fifty-nine patients received PCI according to consensus of the Heart Team in our institute and patients’ consents. Overall severity of coronary stenosis and complexity in each patient was quantified by both the SYNTAX score and Gensini score, and patients were divided into high score group and low score group by the mean of the score in overall patients. Follow-up period was 15.9 ± 14.4 months, and MACE was defined as a composite of cardiac death, myocardial infarction, target vessel revascularization and/or congestive heart failure. Results: The mean SYNTAX score and Gensini score were 19.0 ± 12.4 and 47.8 ± 26.9, respectively. Long-term MACE in a group with high SYNTAX score (≧19, n=71) tended to be higher than a group with low SYNTAX score (<19, n=78), but not significant (Figure 1). However, long-term MACE was significantly higher in a group with high Gensini score (≧48, n=62) than that in a group with low Gensini score (<48, n=97) (Figure 2). In receiver operating characteristic curve analysis, optimal cut-off value of Gensini score to predict MACE was 66.5, of which sensitivity and specificity were 41.2% and 85.6%, respectively (area under curve 0.63, p=0.008). Conclusion: Gensini score is not inferior to SYNTAX in prediction of the clinical outcome after PCI in patients with stable CAD. Prognosis after PCI is favorable in patients with low Gensini score (especially those with GS<66.5).
Published Version
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