Value of syntax score II for predicting in-hospital and long-term survival in octogenarians with ST-segment elevation myocardial infarction: A comparison of six different risk scores

Abstract

BackgroundThe aim of this study was to evaluate the usefulness of the Syntax Score II (SSII) in predicting in-hospital and long-term mortality in octogenarians who presented with ST-segment elevation myocardial infarction (STEMI) and were treated with primary percutaneous coronary intervention (pPCI) in addition to compare SS II with other risk-scoring systems. MethodsWe retrospectively enrolled 312 consecutive STEMI patients in the eighth decade of life or older who underwent pPCI. The octogenarians were divided into two groups according to their median SSII (low SSII ≤ 43.6 and high SSII > 43.6), and these groups were compared in terms of mortality. The performance of the SSII in predicting patients’ outcomes was further compared with that of other well-known risk-scoring systems. ResultsIn the study, the SSII was an independent predictor of long-term mortality (OR: 1.036 95% CI: 1.005–1.068; p = 0.024). Both in-hospital (20.8% vs. 1.2%; p < 0.001) and long-term mortality (45.0% vs. 11%; p < 0.001) were higher among the patients with a high SSII compared to those with a low SSII. An ROC curve comparison showed that SSII was a better predictor (AUC: 0.807; 95% CI: 0.750-0.863) of long-term mortality than SS, PAMI, TIMI, and GRACE risk scores but not CADILLAC. ConclusionsBased on the study findings, octogenarians with a high SSII had worse in-hospital and long-term survival. The SSII, which includes several clinical and anatomical parameters, may be a better predictor of mortality than other risk-scoring systems in octogenarians.