Assessment of the SYNTAX score in the Syntax study

被引：470

作者：

Serruys, Patrick W. ^{[1
]}

Onuma, Yoshinobu ^{[1
]}

Garg, Scot ^{[1
]}

Sarno, Giovanna ^{[1
]}

van den Brand, Marcel

Kappetein, Arie-Pieter ^{[2
]}

Van Dyck, Nic ^{[3
]}

Mack, Michael ^{[4
]}

Holmes, David ^{[5
]}

Feldman, Ted ^{[6
]}

Morice, Marie-Claude ^{[7
]}

Colombo, Antonio ^{[8
]}

Bass, Eric ^{[9
]}

Leadley, Katrin ^{[9
]}

Dawkins, Keith D. ^{[9
]}

van Es, Gerrit-Anne ^{[10
]}

Morel, Marie-Angele M. ^{[10
]}

Mohr, Friedrich W. ^{[11
]}

机构：

[1] Thorax Ctr Rotterdam, Erasmus Med Ctr, Dept Intervent Cardiol, NL-3015 CE Rotterdam, Netherlands

[2] Thorax Ctr Rotterdam, Erasmus Med Ctr, Dept Cardiothorac Surg, NL-3015 CE Rotterdam, Netherlands

[3] Boston Sci Corp, Maastricht, Netherlands

[4] Med City Dallas Hosp, Dallas, TX USA

[5] Mayo Clin, Rochester, MN USA

[6] Northwestern Univ, Evanston Hosp, Evanston, IL 60201 USA

[7] Inst Cardiovasc Paris Sud, Massy, France

[8] Hosp San Raffaele, I-20132 Milan, Italy

[9] Boston Sci Corp, Natick, MA USA

[10] Cardialysis BV, Rotterdam, Netherlands

[11] Herzzentrum, Leipzig, Germany

来源：

EUROINTERVENTION | 2009年 / 5卷 / 01期

关键词：

SYNTAX score; SYNTAX study; complex lesions; percutaneous coronary intervention; coronary artery bypass surgery;

D O I：

10.4244/EIJV5I1A9

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims: The SYNTAX (TM) score has been designed to better anticipate the risks of percutaneous or surgical revascularisation, taking into account the functional impact of the coronary circulation with all its anatomic components including the presence of bifurcations, total occlusions, thrombus, calcification, and small vessels. The purpose of this paper is to describe the baseline assessment of the SYNTAX (TM) score in the Syntax randomised trial, the corelab reproducibility, the potential difference in score assessment between the investigator and the corelab, and to ascertain the impact on one-year outcome after either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) in patients with complex coronary artery disease. Methods and results: To assess the reliability of Syntax (TM) scoring, 100 diagnostic angiograms from the Syntax trial were randomly selected and assessed independently by two observers. Intra-observer variability was assessed by analysing 91 sets of angiograms after an interval of at least eight weeks by one of the observers. Clinical outcomes in the randomised cohort of the Syntax trial up to one year are presented with stratification by tertile group of the SYNTAX (TM) score. The weighted kappa value for the inter-observer reproducibility on the global score was 0.45, while the intra-observer weighted kappa value was 0.59. The SYNTAX (TM) score as calculated by investigators consistently underscored the corelab score by 3.4 points. When the Syntax randomised cohort was stratified by tertiles of the SYNTAX (TM) score, there were similar or non-significantly different MACCE rates in those with low or intermediate scores; however in the top tertile the MACCE rate was greater in those receiving PCI compared to CABG. Conclusions: The SYNTAX (TM) score is a visual coronary score with an acceptable corelab reproducibility that has an impact on the one-year outcome of those having PCI, whereas it has no effect on the one-year outcome following surgical revascularisation. The SYNTAX (TM) score tool is likely to be useful in a wide range of patients with complex coronary disease.

引用

页码：50 / 56

页数：7

共 17 条

[1]

BANNING AP, 2009, LANCET IN PRESS

[2] ACCURACY OF INDIVIDUAL AND PANEL VISUAL INTERPRETATIONS OF CORONARY ARTERIOGRAMS - IMPLICATIONS FOR CLINICAL DECISIONS [J].