Skip to main content

Advertisement

SpringerLink
Log in

Comparison of SYNTAX score II efficacy with SYNTAX score and TIMI risk score for predicting in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

SYNTAX score II (SS-II) has a powerful prognostic accuracy in patients with stable complex coronary artery disease who have undergone revascularization; however, there is limited data regarding the prognosis of patients with ST segment elevation myocardial infarction (STEMI). The aim of this study is to examine both the predictive performance of SS-II in determining in-hospital and long term mortality of STEMI patients and to compare SYNTAX score (SS) and TIMI risk score (TRS). Consecutive 1912 STEMI patients treated with primary percutaneous coronary intervention (p-PCI) retrospectively reviewed, and the remaining 1708 patients constituted the study population after exclusion. The patients were divided into three groups according to increased SS-II value: low (n:562; SS-II ≤ 24.6); intermediate (n:563; 24.6 < SS-II < 34.4); and high tertile (n:583; SS-II ≥ 34.4). In-hospital and long term mortality rate from all causes (0 vs. 0.5 vs. 10.6% and 1.8 vs. 3.2 vs. 18.1% respectively, p ≤ 0.001) were significantly increased with SS-II tertiles and SS-II was found to be independent predictor of in-hospital and long term mortality (HR: 1.076 95% CI 1.060–1.092, p < 0.001) and (HR: 1.070 95% CI 1.050–1.090, p < 0.0001). The predictive power of SS-II, SS, and TRS were compared by ROC curve and decision curve analysis. SS-II surpassed SS and TRS in long-term and in-hospital mortality prediction. SS-II is a powerful tool to predict in-hospital and long-term mortality from all causes in STEMI patients treated with p-PCI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Flowchart
Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Steg PG et al (2012) ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 33:2569–2619

    Article  PubMed  CAS  Google Scholar 

  2. Sidney S et al (2013) The “heart disease and stroke statistics–2013 update” and the need for a national cardiovascular surveillance system. Circulation 127(1):21–23

    Article  PubMed  Google Scholar 

  3. Magro M et al (2011) Value of the SYNTAX score in patients treated by primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: the MI SYNTAXscore study. Am Heart J 161(4):771–781

    Article  PubMed  Google Scholar 

  4. Morrow DA et al (2000) TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation. Circulation 102(17):2031–2037

    Article  PubMed  CAS  Google Scholar 

  5. Endo A et al (2015) Angiographic lesion complexity score and in-hospital outcomes after percutaneous coronary intervention. PLoS ONE 10(6):e0127217

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Yang CH et al (2013) The prognostic significance of SYNTAX score after early percutaneous transluminal coronary angioplasty for acute ST elevation myocardial infarction. Heart Lung Circ 22(5):341–345

    Article  PubMed  Google Scholar 

  7. Yang CH et al (2012) SYNTAX score: an independent predictor of long-term cardiac mortality in patients with acute ST-elevation myocardial infarction. Coron Artery Dis 23(7):445–449

    Article  PubMed  Google Scholar 

  8. Ong AT et al (2006) The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) study: design, rationale, and run-in phase. Am Heart J 151(6):1194–1204

    Article  PubMed  Google Scholar 

  9. Popovic B et al (2016) Prognostic value of the thrombolysis in myocardial infarction risk score in ST-elevation myocardial infarction patients with left ventricular dysfunction (from the EPHESUS Trial). Am J Cardiol 118(10):1442–1447

    Article  PubMed  Google Scholar 

  10. Rivera-Fernandez R et al (2016) Prolonged QT interval in ST-elevation myocardial infarction and mortality: new prognostic scale with QT, Killip and age. J Cardiovasc Med 17(1):11–19

    Article  Google Scholar 

  11. Freisinger E, Malyar NM, Reinecke H (2016) Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting. Vasa 45(2):169–174

    Article  PubMed  Google Scholar 

  12. Polikutina OM et al (2015) Impact of chronic obstructive pulmonary disease on one-year prognosis in patients with ST-segment elevation myocardial infarction. Ter Arkh 87(9):52–57

    Article  PubMed  CAS  Google Scholar 

  13. Lang R et al (2005) American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463

    Article  PubMed  Google Scholar 

  14. Satogami K et al (2017) Impact of plaque Rupture detected by optical coherence tomography on transmural extent of infarction after successful stenting in ST-segment elevation acute myocardial infarction. JACC Cardiovasc Interv 10(10):1025–1033

    Article  PubMed  Google Scholar 

  15. Sianos G et al (2005) The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention 1(2):219–227

    PubMed  Google Scholar 

  16. Farooq V et al (2013) Anatomical and clinical characteristics to guide decision making between coronary artery bypass surgery and percutaneous coronary intervention for individual patients: development and validation of SYNTAX score II. Lancet 381(9867):639–650

    Article  PubMed  Google Scholar 

  17. Sianos G, Papafaklis MI, Serruys PW (2010) Angiographic thrombus burden classification in patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. J Invasive Cardiol 22:6B–14B

    PubMed  Google Scholar 

  18. Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, McCabe CH, Raymond L, Fortin T, Poole WK, Braunwald E (1996) TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 93:879–888

    Article  PubMed  CAS  Google Scholar 

  19. Overgaard CB et al (2013) Percutaneous revascularization and long term clinical outcomes of diabetic patients randomized in the Occluded Artery Trial (OAT). Int J Cardiol 168(3):2416–2422

    Article  PubMed  Google Scholar 

  20. Steyerberg EW, Vickers AJ (2008) Decision curve analysis: a discussion. Med Decis Making 28(1):146–149

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wang G et al (2016) Usefulness of the SYNTAX score II to predict 1-year outcome in patients with primary percutaneous coronary intervention. Coron Artery Dis 27:483–489

    Article  PubMed  Google Scholar 

  22. Farooq V et al (2013) Prediction of 1-year mortality in patients with acute coronary syndromes undergoing percutaneous coronary intervention: validation of the logistic clinical SYNTAX (Synergy between Percutaneous Coronary Interventions with Taxus and Cardiac Surgery) score. JACC Cardiovasc Interv 6(7):737–745

    Article  PubMed  Google Scholar 

  23. Scherff F et al (2011) The SYNTAX score predicts early mortality risk in the elderly with acute coronary syndrome having primary PCI. J Invasive Cardiol 23(12):505–510

    PubMed  Google Scholar 

  24. Campos CM, Garcia-Garcia HM, van Klaveren D, Ishibashi Y, Cho YK, Valgimigli M et al (2015) Validity of SYNTAX score II for risk stratification of percutaneous coronary interventions: a patient-level pooled analysis of 5433 patients enrolled in contemporary coronary stent trials. Int J Cardiol 187:111–115

    Article  PubMed  Google Scholar 

  25. Palmerini T et al (2011) Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial. J Am Coll Cardiol 57(24):2389–2397

    Article  PubMed  Google Scholar 

  26. Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E (2000) TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation: an intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation 102:2031–2037

    Article  PubMed  CAS  Google Scholar 

  27. Morrow DA, Antman EM, Parsons L, de Lemos JA, Cannon CP, Giugliano RP, McCabe CH, Barron HV, Braunwald E (2001) Application of the TIMI risk score for ST-elevation MI in the National Registry of Myocardial Infarction 3. JAMA 286:1356–1359

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank http://www.metastata.com for their contributions to statistical analysis and trial design.

Author information

Authors and Affiliations

  1. Department of Cardiology, Kafkas University, Kars, Turkey

    Yavuz Karabağ, Metin Çağdaş, Ibrahim Rencuzogullari, Süleyman Karakoyun, İnanç Artaç & Doğan İliş

  2. Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey

    Mahmut Yesin

  3. Department of Anesthesia and Reanimation, Kafkas University, Kars, Turkey

    Mesut Öterkus

  4. Department of Cardiology, Medipol University, Istanbul, Turkey

    Tayyar Gokdeniz

  5. Department of Cardiology, Midyat State Hospital, Mardin, Turkey

    Cengiz Burak

  6. Department of Cardiology, Ataturk University, Erzurum, Turkey

    Ibrahim Halil Tanboğa

Authors
  1. Yavuz Karabağ
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Metin Çağdaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ibrahim Rencuzogullari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Süleyman Karakoyun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. İnanç Artaç
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Doğan İliş
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mahmut Yesin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mesut Öterkus
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tayyar Gokdeniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Cengiz Burak
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ibrahim Halil Tanboğa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yavuz Karabağ.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karabağ, Y., Çağdaş, M., Rencuzogullari, I. et al. Comparison of SYNTAX score II efficacy with SYNTAX score and TIMI risk score for predicting in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction. Int J Cardiovasc Imaging 34, 1165–1175 (2018). https://doi.org/10.1007/s10554-018-1333-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-018-1333-1

Keywords

Search

Navigation