Abstract
Background: The residual SYNTAX score (RSS) can be used to measure the residual stenosis severity and complexity. The prognostic role of RSS in CCS patients is still unknown. We purposed to investigate the impact of RSS on the clinical outcomes following PCI in CCS patients. Methods: A prospective cohort study was performed. Based on the residual SYNTAX score, patients were divided into three groups: RSS 0, RSS 0 to 9.5, and RSS >9.5. The primary outcome was patient-oriented composite endpoint (POCE), including repeat revascularization, myocardial infarction, and all-cause mortality. Results: After 1-year follow-up period, patients in RSS >9.5 group revealed the greater POCE (4.3% vs. 6.4% vs. 23.9%; p = 0.016) than others. The repeat revascularization rate also was greater in the RSS >9.5 group (0.0% vs. 6.4% vs. 19.6%; p = 0.012). However, the hospitalization due to angina rates in all groups was not significantly different (4.3% vs. 4.2% vs. 4.3%; p = 1.000). The multivariate analysis revealed that RSS >9.5 was the strong predictor for repeat revascularization during 1 year follow-up (Odds ratio [OR] = 9.605; 95% confidence interval [CI] = 1.207 - 76.458; p = 0.033). Conclusion: The greater RSS was associated with the higher 1-year POCE and repeat revascularization rate in CCS patients. The high RSS was also the strong predictor for 1-year repeat revascularization for CCS patients.
Highlights
Coronary artery disease (CAD) is a chronic disease due to atherosclerotic plaque generation in the epicardial coronary arteries.[1,2] Globally, CAD has been recognized as the number one cause of death.[2,3] Every year, at least 470,000 Indonesian people are estimated to die due to stroke or CAD.[4]
Patients in residual SYNTAX score (RSS) >9.5 group revealed a greater proportion of three-vessel disease (8.7% vs. 59.6% vs. 76.1%; p
We evaluated the severity of incomplete revascularization using RSS and its effect on the clinical outcomes in chronic coronary syndromes (CCS) patients
Summary
Coronary artery disease (CAD) is a chronic disease due to atherosclerotic plaque generation in the epicardial coronary arteries.[1,2] Globally, CAD has been recognized as the number one cause of death.[2,3] Every year, at least 470,000 Indonesian people are estimated to die due to stroke or CAD.[4]. Acute coronary syndromes (ACS) and chronic coronary syndromes (CCS) are the clinical manifestations of CAD.[1] The CCS is a new terminology that replaces “stable CAD.” It is a progressive atherosclerotic plaque accumulation process accompanied by functional changes in the epicardial coronary artery.[1] Myocardial revascularization through coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) are the cornerstones of the CCS treatment strategy.[1,5] Complete revascularization has to be achieved during conducting PCI or CABG. Results: After 1-year follow-up period, patients in RSS >9.5 group revealed the greater POCE (4.3% vs 6.4% vs 23.9%; p = 0.016) than others. Conclusion: The greater RSS was associated with the higher 1-year POCE and repeat revascularization rate in CCS patients. The high RSS was the strong predictor for 1-year repeat revascularization for CCS patients
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