scholarly journals Prognostic value of characteristics of plaque combined with residual syntax score among patients with STEMI undergoing primary PCI: an intravascular optical coherence tomography study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaoxiao Zhao ◽  
Ying Wang ◽  
Runzhen Chen ◽  
Jiannan Li ◽  
Jinying Zhou ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Prognostic Value ◽  
Syntax Score ◽  
Primary Pci ◽  
Plaque Erosion ◽  
Acute Mi ◽  
Intravascular Optical Coherence Tomography ◽  
Residual Syntax Score

Abstract Aim The present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI. Methods and outcomes A total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P = 0.005), plaque erosion (P = 0.045), macrophage infiltration (P = 0.026), and calcification (P = 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846. Conclusion The results of this study could be used in clinical practice to support risk stratification. Trial registration This study was registered at ClinicalTrials.gov as NCT03593928.

scholarly journals Prognostic Value of Characteristics of Plaque Combined With Residual Syntax Score Among Patients With STEMI Undergoing Primary PCI: an Intravascular Optical Coherence Tomography Study

2021 ◽  
Author(s):  
Xiaoxiao Zhao ◽  
Ying Wang ◽  
Runzhen Chen ◽  
Jiannan Li ◽  
Jingying Zhou ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Prognostic Value ◽  
Syntax Score ◽  
Primary Pci ◽  
Plaque Erosion ◽  
Acute Mi ◽  
Intravascular Optical Coherence Tomography ◽  
Residual Syntax Score

Abstract AimThe present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI.Methods and outcomesA total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P= 0.005), plaque erosion (P= 0.045), macrophage infiltration (P= 0.026), and calcification (P= 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846.ConclusionThe results of this study could be used in clinical practice to support risk stratification.Trial registrationThis study was registered at ClinicalTrials.gov as NCT03593928.

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 >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 >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 < 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.

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