Association of syntax score with short-term outcomes among acute ST-elevation myocardial infarction patients undergoing primary PCI

Sarita Choudhary, Sarita Choudhary

Abstract

Objective: Syntax score (SX) has emerged as a reproducible angiographic tool to quantify the extent of coronary artery disease based on location and complexity of each lesion. It has been shown to predict long-term clinical outcomes in patients with left main or multi-vessel disease and recently also in ST-segment elevation myocardial infarction undergoing primary PCI. The aim of this study was to evaluate whether the syntax score is associated with short-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI).

Methods: Syntax score was determined in 90 consecutive patients (mean age 54.2±11.6) of STEMI undergoing primary PCI. Outcomes were stratified according to syntax score groups: SX low ≤15 (n=33), SX mid 16-22 (n=30), and SX high ≥23 (n=27). The primary endpoint was all-cause mortality at 30 days. Secondary endpoints were nonfatal major adverse cardiac and cerebrovascular events (MACE) defined as a composite of any repeat revascularization, acute coronary syndrome, and stroke at 30 days in patients discharged alive.

Results: Mortality at 30 days was higher in the SX high group compared to the SX mid and SX low group (18.5% vs 3.3% p=0.011), MACE at 30 days was higher in SX high group compared to SX mid and SX low group (48.1% vs 16.6% vs 9.1%, p=0.001).

Conclusions: The syntax score is associated with 30-day mortality in patients with STEMI undergoing primary PCI. In those discharged, it is associated with risk of MACE at 30 days.

Keywords: Mortality; Myocardial infarction; PCI; STEMI; SYNTAX score.

Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

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