The Prognostic Utility of the SYNTAX Score on 1-Year Outcomes After Revascularization With Zotarolimus- and Everolimus-Eluting Stents A Substudy of the RESOLUTE All Comers Trial

被引：90

作者：

Garg, Scot

Serruys, Patrick W. ^{[1
]}

Silber, Sigmund ^{[2
]}

Wykrzykowska, Joanna

van Geuns, Robert Jan

Richardt, Gert ^{[3
]}

Buszman, Pawel E. ^{[4
]}

Kelbaek, Henning ^{[5
]}

van Boven, Adrianus Johannes ^{[6
]}

Hofma, Sjoerd H. ^{[6
]}

Linke, Axel ^{[7
]}

Klauss, Volker ^{[8
]}

Wijns, William ^{[9
]}

Macaya, Carlos ^{[10
]}

Garot, Philippe ^{[11
]}

DiMario, Carlo ^{[12
]}

Manoharan, Ganesh ^{[13
]}

Kornowski, Ran ^{[14
]}

Ischinger, Thomas ^{[15
]}

Bartorelli, Antonio ^{[16
]}

Van Remortel, Eric ^{[18
]}

Ronden, Jacintha ^{[18
]}

Windecker, Stephan ^{[17
]}

机构：

[1] Erasmus MC, Dept Intervent Cardiol, Thoraxctr, NL-3015 CE Rotterdam, Zuid Holland, Netherlands

[2] Kardiol Praxis & Praxisklin, Dept Cardiol, Munich, Germany

[3] Segeberger Kliniken GmbH, Dept Cardiol, Herz Kreislauf Zentrum, Bad Segeberg, Germany

[4] Med Univ Silesia, Dept Cardiol, Katowice, Poland

[5] Rigshosp, DK-2100 Copenhagen, Denmark

[6] Med Ctr Leeuwarden, Dept Cardiol, Leeuwarden, Netherlands

[7] Herzzentrum Leipzig, Dept Cardiol, Leipzig, Germany

[8] Univ Hosp Munich Innenstadt, Dept Cardiol, Munich, Germany

[9] Onze Lieve Vrouw Hosp, Dept Cardiol, Aalst, Belgium

[10] Univ Hosp, Serv Cardiol, Madrid, Spain

[11] Inst Cardiovasc Paris Sud, Dept Cardiol, Quincy, France

[12] Royal Brompton Hosp, Dept Cardiol, London SW3 6LY, England

[13] Royal Victoria Hosp, Belfast BT12 6BA, Antrim, North Ireland

[14] Tel Aviv Univ, Rabin Med Ctr, Dept Cardiol, IL-69978 Tel Aviv, Israel

[15] Hosp Bogenhausen, Dept Cardiol, Munich, Germany

[16] IRCCS, Ctr Cardiol Monzino, Dept Cardiol, Milan, Italy

[17] Univ Hosp Bern, Dept Intervent Cardiol, CH-3010 Bern, Switzerland

[18] Cardialysis, Rotterdam, Netherlands

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2011年 / 4卷 / 04期

关键词：

everolimus-eluting stent(s); resolute zotarolimus-eluting stent(s); SYNTAX score; PERCUTANEOUS CORONARY INTERVENTION; MYOCARDIAL-INFARCTION; CLINICAL-OUTCOMES; SUBGROUP ANALYSES; ARTERY-DISEASE; RISK; PREDICTION; TAXUS;

D O I：

10.1016/j.jcin.2011.01.008

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents. Background The SXscore can identify patients treated with PCI who are at highest risk of adverse events. Methods The SXscore was calculated prospectively in 2,033 of the 2,292 patients enrolled in the RESOLUTE All Corners study (RESOLUTE III All Corners Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention). Clinical outcomes in terms of a patient-oriented composite endpoint (POCE) of all-cause death, myocardial infarction (MI), and repeat revascularization; the individual components of POCE; target lesion failure (TLF) (a composite of cardiac death, target-vessel MI, and clinically driven target lesion revascularization); and stent thrombosis were subsequently stratified according to SXscore tertiles: SXscore(LOW) <= 9 (n = 698), 9 < SXscore(MID) <= 17 (n = 676); SXscore(HIGH) > 17 (n = 659). Results At 12-month follow-up, rates of POCE, MI, repeat revascularization, TLF, and the composite of death/MI were all significantly higher in patients in the highest SXscore tercile. Rates of stent thrombosis were all highest in the SXscore(HIGH) tertile (p > 0.05). After multivariate adjustment, the SXscore was identified as an independent predictor of POCE, MI, repeat revascularization, and TLF (p < 0.05 for all). At 12-month follow-up, the SXscore, ACEF score, and Clinical SXscore had C-statistics of 0.57, 0.78, and 0.67, respectively, for mortality and of 0.62, 0.56, 0.63, respectively, for POCE. No significant between-stent differences were observed for TLF or POCE in any of the SXscore tertiles. Conclusions The SYNTAX score is able to stratify risk amongst an all-corners population treated with PCI with second-generation drug-eluting stents (DES); however, improvements can be made with the inclusion of clinical variables. (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084) (J Am Coll Cardiol Intv 2011;4:432-41) (C) 2011 by the American College of Cardiology Foundation

引用

页码：432 / 441

页数：10

共 26 条

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[Anonymous], AM COLL CARD M MARCH

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