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Erschienen in: Heart and Vessels 6/2016

23.04.2015 | Original Article

Incremental prognostic value of the SYNTAX score to late gadolinium-enhanced magnetic resonance images for patients with stable coronary artery disease

verfasst von: Shingo Kato, Naka Saito, Hidekuni Kirigaya, Daiki Gyotoku, Naoki Iinuma, Yuka Kusakawa, Kohei Iguchi, Tatsuya Nakachi, Kazuki Fukui, Masaaki Futaki, Tae Iwasawa, Masataka Taguri, Kazuo Kimura, Satoshi Umemura

Erschienen in: Heart and Vessels | Ausgabe 6/2016

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Abstract

The prognostic significance of the SYNTAX (Synergy between PCI with Taxus and cardiac surgery) score has recently been demonstrated in patients with stable multivessel or left main coronary artery disease (CAD). The present study determines whether adding the SYNTAX score to Framingham risk score (FRS), left ventricular ejection fraction (LVEF) and presence of myocardial infarction (MI) by late gadolinium enhancement (LGE) magnetic resonance imaging can improve the risk stratification in patients with stable CAD. We calculated the SYNTAX score in 161 patients with stable CAD (mean age: 66 ± 10 years old). During a mean follow-up of 2.3 years, 56 (35 %) of 161 patients developed cardiovascular events defined as cardiovascular death, non-fatal MI, cerebral infarction, unstable angina pectoris, hospitalization due to heart failure and revascularization. Multivariate Cox regression analysis selected triglycerides [hazard ratio (HR): 1.005 (95 % confidence interval (CI): 1.001–1.008), p < 0.008], presence of LGE [HR: 6.329 (95 % CI: 2.662–15.05), p < 0.001] and the SYNTAX score [HR: 1.085 (95 % CI: 1.044–1.127), p < 0.001] as risk factors for future cardiovascular events. Adding the SYNTAX score to FRS, EF and LGE significantly improved the net reclassification index (NRI) [40.4 % (95 % CI: 18.1–54.8 %), p < 0.05] with an increase in C-statistics of 0.089 (from 0.707 to 0.796). An increase in C-statistics and significant improvement of NRI showed that adding the SYNTAX score to the FRS, LVEF and LGE incrementally improved risk stratification in patient with stable CAD.
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Metadaten
Titel
Incremental prognostic value of the SYNTAX score to late gadolinium-enhanced magnetic resonance images for patients with stable coronary artery disease
verfasst von
Shingo Kato
Naka Saito
Hidekuni Kirigaya
Daiki Gyotoku
Naoki Iinuma
Yuka Kusakawa
Kohei Iguchi
Tatsuya Nakachi
Kazuki Fukui
Masaaki Futaki
Tae Iwasawa
Masataka Taguri
Kazuo Kimura
Satoshi Umemura
Publikationsdatum
23.04.2015
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 6/2016
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-015-0685-x

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