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Outcomes After Left Main Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting According to Lesion Site Results From the EXCEL Trial Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease Design and rationale for a randomised comparison of everolimus-eluting stents and coronary artery bypass graft surgery in selected patients with left main coronary artery disease: the EXCEL trial Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial Left Main Revascularization With PCI or CABG in Patients With Chronic Kidney Disease: EXCEL Trial Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial Current treatment of significant left main coronary artery disease: A review Quality of Life after Everolimus-Eluting Stents or Bypass Surgery for Treatment of Left Main Disease
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Clinical Trial12 Sep 2017, [Epub ahead of print]

JOURNAL：Catheter Cardiovasc Interv. Article Link

Usefulness of the SYNTAX score II to validate 2-year outcomes in patients with complex coronary artery disease undergoing percutaneous coronary intervention: A large single-center study

Song Y, Gao Z, Tang X et al. Keywords: complex PCI; left main coronary disease; percutaneous coronary intervention; risk stratification

ABSTRACT

Objective - This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice.


Background - Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI.


Methods - We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013. Patients were stratified according to SS-II for PCI tertiles as follows: SS-II ≤ 20 (n = 1474); SS-II 20-26 (n = 1462); and SS-II > 26 (n = 1462). The predictive ability for 2-year mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.


Results - Mortality was significantly higher in the upper tertile than in the intermediate or lower tertiles during the 2-year follow-up (2.7% vs 1.7% vs 0.5%, respectively; P < 0.001). Multivariate analysis showed that SS-II was an independent predictor of 2-year mortality (hazard ratio: 1.66, 95% confidence interval: 1.03-2.68; P = 0.04). After adjusting for multivariable factors, SS-II had better prediction of 2-year mortality than baseline SS (C-index: SS-II = 0.740 vs baseline SS = 0.620; P < 0.001).


Conclusions - As a risk score combining both anatomical and clinical variables, SS-II demonstrated superiority compared with the purely angiographic SS to predict 2-year mortality in a clinical population of patients with severe CAD undergoing temporary PCI.


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