Prognosis Evaluation of Universal Coronary Heart Disease: The Interplay between SYNTAX Score and ApoB/ApoA1
Abstract Object:To assess the prognosis value of different kinds of SYNTAX score together with apoB/apoA1 in universal coronary heart disease (Regardless of coronary lesion). Method:396 patients undergoing percutaneous coronary intervention(PCI)and coronary stenting from 2013 to 2014 were chosen and recorded the major adverse cardiovascular events (MACE) and quality of life during the next 5 years. According to SYNTAX and SYNTAX II score, the patients were divided into low-risk, medium-risk and high-risk groups, and the clinical features, MACE incidence and EQ-5D score at each time points were compared. And the predictive factors of MACE incidence were analyzed. Results:①Compared with SYNTAX low-risk group, MACE incidence in 1 year significantly increased in medium-high risk group(p=0.011). Compared with SYNTAX II low-risk group, MACE incidence in 5 years significantly increased in medium and high-risk group(p=0.032).② Compared with SYNTAX II low-risk group,cardiovascular mortality in 3 and 5 years significantly elevated in high-risk group(p=0.001,p<0.001 respectively). ③ Compared with SYNTAX II low and medium-risk group, EQ-5D score in 5 years significantly decreased in high-risk group(p=0.001). ④ ApoB/ApoA1 was more likely to be classified as high risk in SYNTAX/SYNTAX II medium and high-risk group(p=0.023,p=0.044 respectively). ⑤Logistic regression analysis showed that apoB/apoA1 was an independent predictor of MACE events in hospital and 5 years(p=0.032,p=0.016 respectively),SYNTAX score was an independent predictor of MACE events in 1 year(medium-risk group:p=0.02;high-risk group:p=0.015)SYNTAX II score was an independent predictor of MACE events in 5 yeasrs(p=0.003). Conclusions:①SYNTAX score has a high predictive value for short-term prognosis while SYNTAX II score is more predictive of long-term prognosis. ② SYNTAX II score is superior to SYNTAX score in predicting cardiovascular death. ③ The combination of apoB/apoA1 high-risk and SYNTAX II medium and high-risk group is the focus of clinical treatment and long-term follow-up observation.