Assessment of Predictive Value of SYNTAX-II Score for Adverse Cardiac Events and Clinical Outcomes in Patients With Acute Coronary Syndrome

Angiology. 2024 Sep;75(8):754-763. doi: 10.1177/00033197231181958. Epub 2023 Jun 9.

Abstract

Prognostic information is important for the management of acute coronary syndrome (ACS). Our aim was to evaluate Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score-II (SSII) for predicting contrast induced nephropathy (CIN) and one-year major adverse cardiac events (MACE) in ACS patients. Coronary angiographic recordings of 1304 ACS patients were retrospectively examined. Predictive values of SYNTAX score (SS), SSII-percutaneous coronary intervention (SSII-PCI), SSII-coronary artery bypass graft (SSII-CABG) scores for CIN and MACE were assessed. Combination of CIN and MACE ratios constituted primary composite end-point. Patients with SSII-PCI scores >32.55 were compared with patients with lower scores. All of the three scoring systems predicted the composite primary end-point [SS: Area under the curve (AUC): .718, P < .001 (95% CI: .689-.747), SSII-PCI: AUC: .824, P < .001 (95% CI: .800-.849), SSII-CABG: AUC: .778, P < .001 (95% CI: .751-.805)]. Comparison of AUC of receiver operating characteristic curves showed that SSII-PCI score had better predictive value than that of SS and SSII-CABG scores. In multivariate analysis, the only predictor of the primary composite end-point was SSII-PCI score (odds ratio: 1.126, 95% CI: 1.107-1.146, P < .001). SSII-PCI score was a valuable tool for prediction of shock, CABG, myocardial infarction, stent thrombosis, development of CIN and one-year mortality.

Keywords: acute coronary syndrome; contrast-Induced nephropathy; major adverse cardiovascular events; syntax score II.

MeSH terms

  • Acute Coronary Syndrome* / mortality
  • Acute Coronary Syndrome* / therapy
  • Aged
  • Contrast Media / adverse effects
  • Coronary Angiography*
  • Coronary Artery Bypass* / adverse effects
  • Drug-Eluting Stents / adverse effects
  • Female
  • Humans
  • Kidney Diseases / diagnosis
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects
  • Percutaneous Coronary Intervention* / adverse effects
  • Predictive Value of Tests*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Contrast Media
  • Paclitaxel