The Association Between SYNTAX Score and Long-term Outcomes in Patients With Unstable Angina Pectoris: a Single-center Retrospective Study

Mapping Intimacies ◽

10.21203/rs.3.rs-530077/v1 ◽

2021 ◽

Author(s):

Min Xu ◽

Hong-Wei Li ◽

Hui Chen

Keyword(s):

Heart Failure ◽

Retrospective Study ◽

Angina Pectoris ◽

Medical Therapy ◽

Cardiac Death ◽

Therapy Group ◽

Syntax Score ◽

Single Center ◽

Long Term Outcomes

Abstract Background: SYNTAX Score affects clinical outcomes in early studies, whether SYNTAX Score could predict long-term outcomes in patients with unstable angina pectoris (UAP) in the era of new generation drug-eluting stent was unclear, and differences by SYNTAX Score in long-term outcomes between the medical therapy and percutaneous coronary intervention (PCI) in UAP patients were not well known.Methods：In this single-center retrospective study, a total of 2,364 patients with UAP from January 2014 to June 2017 at Beijing Friendship Hospital were enrolled. The primary endpoint was a composite of major adverse cardiovascular events (MACE) , including all-cause death, cardiac death, nonfatal myocardial infarction (MI) and stroke after at least 2 year from discharge. Results：In this study, 1,695 patients had low SYNTAX score (<22) , 432 patients had medium SYNTAX score (22-32), and 237 patients had high SYNTAX score (≥33), and 1,018 received medical therapy, 1,346 patients underwent PCI. Long-term MACE occurred in 95 patients during 3.38 ± 0.99 years follow up. Cox multivariate regression analysis showed advanced age, diabetes mellitus, heart failure, chronic kidney disease (CKD) and high SYNTAX score were independent predictors for MACE in the medical therapy group (P < 0.05), while, heart failure and CKD were predictors of MACE in PCI group. Compared to medical therapy group, PCI group showed lower MACE and cardiac death in patients with high SYNTAX score (≥33) (7.4% vs. 16.7%, P = 0.048; 3.7% vs 14.6%, P = 0.004), but no reduction in patients with low- and medium SYNTAX score.Conclusions：High SYNTAX score could predict long-term MACE for UAP patients with medical therapy, but not for patients undergoing PCI. Compared to medical therapy, PCI could significantly reduced long-term MACE and cardiac death for patients with high SYNTAX score.

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Su1617 Long-Term Outcomes of “Resect and Discard” Strategy Using Both Conventional White-Light Imaging and Magnifying Narrow-Band Imaging for Small (≤9MM) Colorectal Polyp: A Single-Center Retrospective Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.846 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB366

Author(s):

Shigetsugu Tsuji ◽

Yasuhito Takeda ◽

Kunihiro Tsuji ◽

Naohiro Yoshida ◽

Shinya Yamada ◽

...

Keyword(s):

Retrospective Study ◽

White Light ◽

Narrow Band ◽

Narrow Band Imaging ◽

Colorectal Polyp ◽

Single Center ◽

Long Term Outcomes ◽

White Light Imaging

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Inferior long-term outcomes of liver-kidney transplantation using donation after cardiac death donors: Single-center and organ procurement and transplantation network analyses

Liver Transplantation ◽

10.1002/lt.23871 ◽

2014 ◽

Vol 20 (6) ◽

pp. 728-735 ◽

Cited By ~ 23

Author(s):

Hani M. Wadei ◽

Ilynn G. Bulatao ◽

Thomas A. Gonwa ◽

Martin L. Mai ◽

Mary Prendergast ◽

...

Keyword(s):

Kidney Transplantation ◽

Cardiac Death ◽

Organ Procurement ◽

Donation After Cardiac Death ◽

Single Center ◽

Long Term Outcomes ◽

Network Analyses

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A comparison of long-term clinical outcomes between PCI and medical therapy in patients with chronic total occlusion in non-Infarct-related arteries after AMI PCI

European Heart Journal ◽

10.1093/eurheartj/ehab724.1444 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

Q Qin ◽

J Ma ◽

J Ge

Keyword(s):

Myocardial Infarction ◽

Medical Therapy ◽

Lower Incidence ◽

Cardiac Death ◽

Chronic Total Occlusion ◽

Long Term Outcomes ◽

Total Occlusion ◽

Kaplan Meier

Abstract Background Chronic total occlusion (CTO) in a non-infarct-related artery (IRA) is one of the risk factors for mortality after acute myocardial infarction (AMI). However, there are limited data comparing the long-term outcomes of patients underwent successful percutaneous coronary intervention (s-PCI) with patients having medical therapy (MT) in CTO lesion after AMI PCI. Methods We retrospectively enrolled 330 patients (n=166 in s-PCI group and n=164 in MT group) with CTO in a non-IRA from a total of 4372 patients who underwent PCI after AMI from July 2011 to July 2019 in our center (Figure 1). Propensity matching (119 matched pairs) was used to adjust for baseline differences. Major adverse cardiovascular and cerebrovascular events (MACCEs) on follow-up were defined as the composite of cardiac death, all cause death, myocardial infarction (MI), stroke and any revascularization. Kaplan-Meier analysis were used to evaluate the long-term outcomes between s-PCI and MT group. Results The patients in MT group were older, more likely to be diagnosed as STEMI, had lower eGFR and higher peak troponin T level during AMI compared with s-PCI group. Furthermore, in MT group, the involvement of LAD as IRA (50.6% vs 38.6%, p=0.028) and LCX as CTO vessel (45.1% vs 27.1%, p=0.001) was more frequent than in s-PCI group, and thus the involvement of LAD as CTO vessel was less frequent (28.9% vs 39.8%, p<0.001). During a median follow-up period of 946 days, patients in s-PCI group had significantly lower incidences of cardiac death (3.0% vs 10.4%, p=0.017) and all cause death (5.4% vs 14.0%, p=0.030) when compared with patients in MT group. Moreover, after PSM, patients in s-PCI group still showed lower incidence of cardiac death (2.5% vs 9.2%, p=0.04). The incidence of MI, stroke, revascularization and MACCE showed no significant difference between the two groups both before and after PSM. In multivariate analysis, age (HR 1.06, 95% CI 1.02–1.10, p=0.003) and LVEF<50% (HR 4.71, 95% CI 1.72–12.90, p=0.003) showed significant correlation with long term cardiac death, however, successful CTO PCI showed borderline significance (HR 0.42, 95% CI 0.15–1.16, p=0.095). In subgroup analysis, Kaplan–Meier curve showed s-PCI group had a lower incidence of cardiac death compared with MT in patients with LVEF<50% both before (p=0.011) and after PSM (p=0.045). However, no difference was observed between two groups in patients with LVEF≥50%. Conclusions In our center, s-PCI of CTO in non-IRA after AMI PCI showed better long-term cardiac survival as compared with MT. Moreover, patients with low LVEF may be benefit from CTO PCI in non-IRA. FUNDunding Acknowledgement Type of funding sources: None. Flow chart of the study Kaplan-Meier analysis between two groups

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