Association of CABG SYNTAX score with long term clinical outcomes in patients with acute myocardial infarction undergoing SVG PCI

Ö.Ç. Karaaslan, O. Maden, Y. Kanal, İ. Yakut, N.M. Yaman, H.C. Könte, M.T. Selçuk, H. Selçuk

Department of Cardiology, Ankara City Hospital, Ankara, Turkey. [email protected]

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• Cardiac surgery

OBJECTIVE: The CABG SYNTAX score (CSS) has been recommended as an objective and quantitative evaluation tool for coronary anatomic complexity after CABG. We aimed at evaluating the long-term prognostic value of the CSS and its relationship with the composite criteria of all-cause death, cerebrovascular accident (CVA) and/or non-fatal myocardial infarction (MI) in patients who underwent percutaneous coronary intervention (PCI) of saphenous vein graft (SVG).

PATIENTS AND METHODS: We retrospectively evaluated 232 patients who were admitted with MI and underwent PCI of SVGs, between 2012 and 2018. The study population was divided into two groups according to the results of the median pre-PCI CSS.

RESULTS: The composite criteria of all-cause death/CVA/non-fatal MI were observed in 107 patients (46.1%). The incidence of the primary endpoint was significantly higher among the patients with a high pre-PCI CSS (p < .001). Multivariable Cox regression analyses demonstrated that both pre-PCI CSS (HR = 1.678, 95% CI = 1.082-2.602, p = .021) and post-PCI CSS (HR = 1.663, 95% CI = 1.066-2.596, p = .025) were significantly associated with the primary endpoint. The Kaplan–Meier cumulative curves divided by the median of the pre-PCI CSS demonstrated that, compared with the low pre-PCI CSS group, the high-score group was associated at five years with higher composite criteria of all-cause death/CVA/non-fatal MI (low, 40.3%; high, 57.8%; p = .015).

CONCLUSIONS: Pre-PCI CSS is a significant prognostic factor for the long-term clinical outcomes in patients with previous CABG who underwent PCI of SVG.

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