Residual SYNTAX score II and complex percutaneous coronary interventions

AbstractMechanical circulatory support (MCS) devices are increasingly used to provide hemodynamic stability for patients with severe coronary artery disease, comorbidities, and/or impaired hemodynamics during high-risk percutaneous coronary interventions (PCI). Vascular access site complications, particularly those due to the use of large-bore sheaths, may limit outcomes in these patients. The aim of this study was to investigate the incidence and predictors of vascular complications in protected high-risk PCIs. Therefore, we included patients undergoing high-risk PCI with an Impella device from January 2016 to August 2018. Vascular complications were graded according to ‘Valve Academic Research Consortium-2’, a definition routinely used in transcatheter valve implantation procedures. In total, 61 patients (mean age 72 ± 11 years, 79% male, SYNTAX score 33 ± 7) were included, and angiographic- and fluoroscopic-guided vascular access was used for Impella implantation in all patients. Major vascular complications occurred in 5 male patients (8%). All major vascular complications were treated conservatively without the need for surgical intervention, and only one patient received a transfusion of three erythrocyte concentrates. Regression analysis revealed that patients with peripheral arterial disease of the lower extremities are at higher risk of major vascular complications. In conclusion, the utilization of Impella using a standardized protocol for angiographic- and fluoroscopic-guided vascular access was associated with a low rate of vascular complications.

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Association of serum uric acid levels with SYNTAX score II and long term mortality in the patients with stable angina pectoris who undergo percutaneous coronary interventions due to multivessel and/or unprotected left main disease

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-018-1446-6 ◽

2018 ◽

Vol 35 (1) ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Yavuz Karabağ ◽

Ibrahim Rencuzogullari ◽

Metin Çağdaş ◽

Süleyman Karakoyun ◽

Mahmut Yesin ◽

...

Keyword(s):

Syntax Score ◽

Percutaneous Coronary Interventions ◽

Stable Angina Pectoris ◽

Left Main ◽

Left Main Disease ◽

Syntax Score Ii ◽

Percutaneous Coronary ◽

Unprotected Left Main Disease ◽

Long Term Mortality

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New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion

Journal of Interventional Cardiology ◽

10.1155/2019/8238972 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Cãlin Homorodean ◽

Adrian Corneliu Iancu ◽

Daniel Leucuţa ◽

Şerban Bãlãnescu ◽

Ioana Mihaela Dregoesc ◽

...

Keyword(s):

Coronary Artery ◽

Cardiogenic Shock ◽

Coronary Intervention ◽

Syntax Score ◽

Syntax Score Ii ◽

Percutaneous Coronary ◽

Artery Disease ◽

Residual Syntax Score

Objectives. The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA). Background. Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients. Methods. 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA. Results. Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049). Conclusions. In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up.

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