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首页> 外文期刊>Circulation journal >Predictive Performance of SYNTAX Score II in Patients With Left Main and Multivessel Coronary Artery Disease – Analysis of CREDO-Kyoto Registry –
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Predictive Performance of SYNTAX Score II in Patients With Left Main and Multivessel Coronary Artery Disease – Analysis of CREDO-Kyoto Registry –

机译：SYNTAX II级评分在左主干和多支冠状动脉疾病患者中的预测表现– CREDO-Kyoto Registry分析–

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Background:SYNTAX score II (SSII) provides individualized estimates of 4-year mortality after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in order to facilitate decision-making between these revascularization methods. The purpose of the present study was to assess SSII in a real-world multicenter registry with distinct regional and epidemiological characteristics.Methods?and?Results:Long-term mortality was analyzed in 3,896 patients undergoing PCI (n=2,190) or CABG (n=1,796) from the Coronary REvascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) PCI/CABG registry cohort-2. SSII discriminated well in both CABG and PCI patient groups (concordance index [c-index], 0.70; 95% CI: 0.68–0.72; and 0.75, 95% CI: 0.72–0.78) surpassing anatomical SYNTAX score (SS; c-index, 0.50; 95% CI: 0.47–0.53; and 0.59, 95% CI: 0.57–0.61). SSII had the best discriminative ability to separate low-, medium- and high-risk tertiles, and calibration plots showed good predictive performance for CABG and PCI groups. Use of anatomical SS as a reference improved the overall reclassification provided by SSII, with a net reclassification index of 0.5 (P<0.01).Conclusions:SSII has robust prognostic accuracy, both in CABG and in PCI patient groups and, compared with the anatomical SS alone, was more accurate in stratifying patients for late mortality in a real-world complex coronary artery disease Eastern population. (Circ J 2014; 78: 1942–1949)
机译：背景：SYNTAX评分II（SSII）提供了冠状动脉搭桥术（CABG）和经皮冠状动脉介入治疗（PCI）后4年死亡率的个性化估计，以便于在这些血运重建方法之间做出决策。本研究的目的是在具有不同区域和流行病学特征的真实多中心注册表中评估SSII。方法和结果：分析了3,896例行PCI（n = 2,190）或CABG（n = 1,796）来自在京都进行的冠状动脉血运重建研究（CREDO-京都）PCI / CABG注册研究组2。 SSII在CABG和PCI患者组中的区分都很好（一致性指数[c-index]，0.70; 95％CI：0.68-0.72; 0.75，95％CI：0.72-0.78），超过了解剖上的SYNTAX得分（SS; c-index） ，0.50; 95％CI：0.47-0.53; 0.59，95％CI：0.57-0.61）。 SSII具有区分低，中和高风险三分位数的最佳判别能力，并且校正图对CABG和PCI组显示出良好的预测性能。使用解剖学SS作为参考可改善SSII提供的总体重分类，净重分类指数为0.5（P <0.01）。结论：SSII在CABG和PCI患者组中以及与解剖学相比均具有强大的预后准确性仅在现实世界中复杂的东部冠心病人群中，仅靠SS就能对患者的晚期死亡进行分层。 （Circ J 2014; 78：1942-1949）

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