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首页> 外文期刊>EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology >The CABG SYNTAX score - An angiographic tool to grade the complexity of coronary disease following coronary artery bypass graft surgery: From the SYNTAX left main angiographic (SYNTAX-LE MANS) substudy
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The CABG SYNTAX score - An angiographic tool to grade the complexity of coronary disease following coronary artery bypass graft surgery: From the SYNTAX left main angiographic (SYNTAX-LE MANS) substudy

机译：CABG SYNTAX评分-冠状动脉搭桥术后对冠脉疾病复杂性进行分级的血管造影工具：来自SYNTAX左主血管造影（SYNTAX-LE MANS）子研究

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Aims: The SYNTAX Score (SXscore) has established itself as an important prognostic tool in patients undergoing percutaneous coronary intervention (PCI). A limitation of the SXscore is the inability to differentiate outcomes in patients who have undergone prior coronary artery bypass graft (CABG) surgery. The CABG SXscore was devised to address this limitation. Methods and results: In the SYNTAX-LE MANS substudy 115 patients with unprotected left main coronary artery disease (isolated or associated with one, two or three-vessel disease) treated with CABG were prospectively assigned to undergo a 15-month coronary angiogram. An independent core laboratory analysed the baseline SXscore prior to CABG. The 15-month CABG SXscore was calculated by a panel of three interventional cardiologists. The CABG SXscore was calculated by determining the standard SXscore in the "native" coronary vessels ("native SXscore") and deducting points based on the importance of the diseased coronary artery segment (Leaman score) that have a functioning bypass graft anastomosed distally. Points relating to intrinsic coronary disease, such as bifurcation disease or calcification, remain unaltered. The mean 15-month CABG SXscore was significantly lower compared to the mean baseline SXscore (baseline SXscore 31.6, SD 13.1; 15-month CABG SXscore 21.2, SD 11.1; p<0.001). Reproducibility analyses (kappa [k] statistics) indicated a substantial agreement between CABG SXscore measurements (k=0.70; 95% CI [0.50-0.90], p<0.001), with the points deducted to calculate the CABG SXscore the most reproducible measurement (k=0.74; 95% CI [0.53-0.95], p<0.001). Despite the limited power of the study, four-year outcome data (Kaplan-Meier curves) demonstrated a trend towards reduced all-cause death (9.1% vs. 1.8%, p=0.084) and death/CVA/MI (16.4% vs. 7.0%, p=0.126) in the low compared to the high CABG SXscore group. Conclusions: In this pilot study the calculation of the CABG SXscore appeared feasible, reproducible and may have a long-term prognostic role in patients with complex coronary disease undergoing surgical revascularisation. Validation of this new scoring methodology is required.
机译：目的：SYNTAX评分（SXscore）已确立其自身作为接受经皮冠状动脉介入治疗（PCI）的患者的重要预后工具。 SXscore的局限性是无法区分先前接受过冠状动脉搭桥术（CABG）手术的患者的结局。 CABG SXscore旨在解决此限制。方法和结果：在SYNTAX-LE MANS亚研究中，前瞻性地将115例接受CABG治疗的未保护的左主冠状动脉疾病（分离或与一，二或三支血管疾病相关或伴有这种疾病）的患者进行了15个月的冠状动脉造影。一个独立的核心实验室在CABG之前分析了基线SXscore。由三个介入心脏病专家组成的小组计算了15个月的CABG SXscore。通过确定“天然”冠状血管中的标准SXscore（“天然SXscore”）并根据患病的冠状动脉节段的重要性（Leaman评分）的扣除点来计算CABG SXscore，该病变具有远端吻合的功能性旁路移植物。与内在性冠状动脉疾病（如分叉疾病或钙化）有关的要点保持不变。与平均基线SXscore相比，平均15个月CABG SXscore显着更低（基线SXscore 31.6，SD 13.1; 15个月CABG SXscore 21.2，SD 11.1; p <0.001）。再现性分析（kappa [k]统计数据）表明，CABG SXscore测量值之间基本吻合（k = 0.70; 95％CI [0.50-0.90]，p <0.001），其中扣除的点是计算CABG SXscore最可再现的测量值（ k = 0.74; 95％CI [0.53-0.95]，p <0.001）。尽管这项研究的能力有限，但四年结局数据（Kaplan-Meier曲线）显示出全因死亡（9.1％vs. 1.8％，p = 0.084）和死亡/CVA/MI（16.4% vs.与高CABG SXscore组相比，低7.0％，p = 0.126）。结论：在这项初步研究中，CABG SXscore的计算似乎是可行的，可重现的，并且可能在接受手术血管重建的复杂冠心病患者中具有长期的预后作用。需要验证这种新的评分方法。

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