scholarly journals Prognostic value of the SYNTAX score on myocardial injury and salvage in STEMI patients after primary percutaneous coronary intervention: a single-center retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guangren Gao ◽  
Lianrong Feng ◽  
Jinguo Fu ◽  
Yi Li ◽  
Zhaoyang Huo ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Infarct Size ◽  
Prognostic Value ◽  
Myocardial Injury ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Myocardial Salvage ◽  
Primary Pci ◽  
Single Center ◽  
Percutaneous Coronary

Abstract Background SYNTAX score (SS) was shown to positively correlate with postprocedural myocardial injury in patients after elective coronary artery intervention, but evidence about the association of SS with myocardial salvage in ST-segment elevation myocardial infarction (STEMI) patients is still needed. This study aimed to evaluate the prognostic value of SS for myocardial injury and salvage assessed by cardiac magnetic resonance (CMR) after primary percutaneous coronary intervention (PCI) in STEMI patients. Methods This single-center retrospective study consecutively enrolled STEMI patients who had undergone primary PCI within 12 h from symptom onset. Both angiography and CMR were performed during hospitalization, and patients were divided into low SS (SS ≤ 22), mediate-high SS (SS > 22) groups. Correlation and multivariable analyses were performed. Results A total of 149 STEMI patients (96 low SS, 53 mediate-high SS) were included. In terms of myocardial injury parameters, there was a positive correlation (p < 0.001, Spearman r = 0.292) between SS and infarct size (IS), and a negative correlation (p < 0.001, Spearman r =  − 0.314) between SS and myocardial salvage index (MSI). In the multivariable model, SS (> 22 as categorical variable, OR = 2.245, 95% CI [1.002–5.053], p = 0.048; as continuous variable, OR = 1.053, 95% CI [1.014–1.095], p = 0.008) was significantly associated with high IS (≥ mean 35.43). The areas under the receiver operating characteristic (ROC) curves of SS for high IS and low MSI (≤ median 28.01) were 0.664 and 0.610. Conclusions In STEMI patients undergoing primary PCI, SYNTAX score positively correlated with infarct size and negatively with myocardial salvage, indicating an independent predictive value of the myocardial injury.

scholarly journals The Incremental Prognostic Value of the Clinical Residual SYNTAX Score for Patients With Chronic Renal Insufficiency Undergoing Percutaneous Coronary Intervention

2021 ◽  
Vol 8 ◽  
Author(s):  
Liqiu Yan ◽  
Peiyao Li ◽  
Yabin Wang ◽  
Dong Han ◽  
Sulei Li ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Renal Insufficiency ◽  
Prognostic Value ◽  
Coronary Intervention ◽  
Mortality Rates ◽  
Syntax Score ◽  
Cardiac Mortality ◽  
Percutaneous Coronary ◽  
Residual Syntax Score ◽  
Incremental Prognostic Value

Background: The residual SYNTAX score (RSS) is considered a powerful prognostic indicator for determining a reasonable revascularization strategy in patients undergoing percutaneous coronary intervention (PCI), but the absence of clinical parameters is one of the limitations of RSS, especially in the chronic renal insufficiency (CRI) comorbidity setting. The present work aimed to investigate the incremental prognostic value of clinical residual SYNTAX score (CRSS) compared with RSS in CRI cases after PCI.Methods: Totally 2,468 consecutive CRI cases who underwent PCI from January 2014 to September 2017 were included in this retrospective analysis. CRSS was obtained by multiplying RSS by the modified ACEF score. Individuals with CRSS &gt;0 were considered to have incomplete revascularization and stratified by CRSS tertiles, the remaining cases constituted the complete revascularization (CR) group. The outcomes between these groups were compared.Results: At a median follow-up of 3 years, compared with CR group, individuals with CRSS &gt;12 showed elevated rates of all clinical outcomes, and those with CRSS ≤ 12 showed similar all-cause and cardiac mortality rates. In multivariable analysis, CRSS was a powerful independent predictive factor of all clinical outcomes. The net reclassification improvement levels of CRSS over RSS for all-cause and cardiac mortality rates were 10.3% (p = 0.007) and 16.4% (p &lt; 0.001), respectively. Compared with RSS, CRSS markedly ameliorated all-cause and cardiac mortality risk stratification.Conclusions: Compared with RSS, CRSS has incremental predictability for long-term all-cause and cardiac mortality in CRI cases following PCI.

Abstract 379: The Prognostic Value of Eosinophil to Leukocyte Ratio in Patients Presenting With ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Takao Konishi ◽  
Naohiro Funayama ◽  
Tadashi Yamamoto ◽  
Daisuke Hotta
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Infarct Size ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Percutaneous Coronary ◽  
St Elevation

Background: Elevated neutrophil to leukocyte ratio in patients with ST-segment elevation myocardial infarction (STEMI) is associated with adverse clinical outcomes. However, whether decreased eosinophil ratio after primary percutaneous coronary intervention (PCI) reflects larger infarct size has not been fully investigated. This study examined the relationship between eosinophil ratio and creatinine kinase-MB (CK-MB) elevation after primary PCI in patients presenting with STEMI. Methods and Results: We analyzed the data of 321 consecutive patients who underwent primary PCI for ST-elevation myocardial infarction between January 2009 and August 2015. Total and each type of leukocyte counts 24 hours after admission were measured. The eosinophil/leukocyte ratio (ER) was calculated as the ratio of eosinophil to leukocyte count. The primary end point was major adverse cardiac event (MACE) and the follow-up period was 180 days. The mean ER and max CK-MB was 0.44±0.65 % and 217.3±224.4 IU/l, respectively. ER obtained 24 hours after admission was inversely correlated with CK-MB concentration (r=-0.37, r2=0.14, P<0.001). MACE within 180 days occurred in 68 patients (21%) including death (9%), myocardial infarction (MI) (1%) and target lesion or vessel revascularization (10%). Patients who had MACE within 180 days had lower ER (0.20±0.51 vs 0.49±0.66, P<0.001) at 24 hours after admission. Conclusions: The decreased ER after primary PCI in patients presenting with STEMI was associated with increased CK-MB concentration, which might indicate larger infarct size, therefore, poor prognosis.

Abstract 15198: Infarct Size in Patients on Chronic Statin Therapy Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nicola Cosentino ◽  
Sarah Cortinovis ◽  
Valentina Milazzo ◽  
Mara Rubino ◽  
Angelo Cabiati ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Infarct Size ◽  
Statin Therapy ◽  
Troponin I ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Vascular Obstruction

Introduction: Statin pre-treatment has been reported to have a cardio-protective effect in patients undergoing elective or urgent percutaneous coronary intervention (PCI). However, data on ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI are still controversial. Hypothesis: We prospectively evaluated the effect of chronic statin therapy on infarct size (IS), myocardial salvage index (MSI), and micro-vascular obstruction in consecutive STEMI patients undergoing primary PCI. Methods: Two-hundred-thirty STEMI patients (mean age 61±11 years, 183 men) who underwent primary PCI were evaluated with cardiac magnetic resonance (CMR) imaging during hospitalization (median 4 days after primary PCI). In all patients, we measured peak troponin I level, while IS, MSI, and micro-vascular obstruction were determined by CMR. Results: Fifty (22%) patients were on chronic statin therapy and showed a significantly lower troponin I peak value when compared to patients without prior statins (54±47 vs. 88±106 ng/ml; P=0.02). At CMR evaluation, IS related to the index event was significantly smaller (12.5±11.5 vs. 18.5±18.5 grams,P=0.05), and MSI was higher (0.68±0.25 vs. 0.52±0.30; P=0.01) in patients with prior statin therapy. Micro-vascular obstruction was also less frequent (10% vs. 20%; P=0.14) in this group. At multivariable analysis, prior statin therapy remained significantly associated with IS and MSI (P=0.05 and P=0.02, respectively). No significant association was observed between index IS and LDL-cholesterol levels at hospital admission in the entire population (P=0.91). Moreover, no relationship between IS or MSI and statin dose (r=-0.10, P=0.56 and r=0.10, P=0.55, respectively), and length of statin treatment (r=-0.06, P=0.71 and r=0.29; P=0.10, respectively) was found. Conclusions: The results of the present study demonstrated that prior statin therapy is associated with significant smaller IS and higher MSI in patients presenting with STEMI and treated with primary PCI. Whether these preliminary findings will translate into a potential therapeutic strategy warrants further research.

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