Impact of SYNTAX score on 10-year outcomes in NSTE-ACS

Abstract

Introduction

The very long-term prognostic effect of Syntax score on mortality is still undetermined.

Objective

The aim of this study was to investigate the long-term impact of SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (SS) on mortality after invasive management in NSTE-ACS.

Method

A total of 292 consecutive patients (median age 62 years) with non-ST-elevation ACS were included, followed up for ≥ 10 years and were compared according to baseline SS.

Results

Among 292 patients with baseline SS, 227 patients (77.7%) had low SS (≤ 22), 32 (10.9%) had intermediate SS (23 to 32), and 33 (11.4%) had high SS (≥ 33). Cardiovascular mortality during the follow-up according to SS group was 15.9%, 31.3% and 54.5% (p < 10-3), respectively (Fig. 1). In multivariable Cox regression analysis, only age and Syntax score were independently associated with patient outcome. Syntax score ≥ 17 showed a sensitivity of 60.9%, specificity of 61.4%. The area under the ROC curve was 0.70 (95% confidence interval of 0.62–0.77).

Conclusion

The discriminative capacity of SS on long-term outcomes was relevant in NSTE-ACS patients.