Am J Cardiovasc Dis 2012;2(3):216-222
Original Article
Impact of SYNTAX score on 1-year clinical outcomes in patients undergoing
percutaneous coronary intervention for unprotected left main coronary
artery
Tsuyoshi Nozue, Ryo Kamijima, Taku Iwaki, Ichiro Michishita
Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan; Division of
Cardiology, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
Received June 25, 2012; accepted July 19, 2012; Epub July 25, 2012; Published August 15, 2012
Abstract: SYNTAX score is an angiographic scoring system that was developed to quantify the number, complexity, and
location of lesions in patients undergoing coronary revascularization. Up to now, the impact of SYNTAX score on clinical
outcomes in patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery (LMCA)
lesions has not been fully examined. Therefore, we evaluate the usefulness of the SYNTAX score and identify the cutoff
point of this score to predict 1-year clinical outcomes in patients undergoing PCI for unprotected LMCA lesions. This was a
single-center retrospective study that included 49 consecutive patients undergoing elective PCI for unprotected LMCA
lesions. We calculated the SYNTAX score and examined the correlations between this score and 1-year clinical outcomes.
Major adverse cardiac events (MACE) occurred in 12 patients (24%): target lesion revascularization in 9 patients (18%),
myocardial infarction in 2 (4%), and cardiac death in 1 (2%). The frequency of MACE was significantly higher in the
intermediate (47%) or high score group (50%) than in the low score group (4%). Furthermore, the SYNTAX score was
significantly higher in the MACE group than in the non-MACE group (31 vs. 22, p = 0.008). Receiver-operating characteristic
curve showed that the SYNTAX score exhibited 83% sensitivity and 76% specificity for predicting the development of MACE
at a cutoff value 26. These results demonstrate that the SYNTAX score could be a useful tool to predict 1-year clinical
outcomes in patients undergoing elective PCI for unprotected LMCA lesions. (AJCD1206006).
Keywords: Coronary artery disease, left main coronary artery, percutaneous coronary intervention, SYNTAX score
Address all correspondence to:
Dr. Tsuyoshi Nozue
Division of Cardiology
Department of Internal Medicine
Yokohama Sakae Kyosai Hospital
Federation of National Public Service Personnel Mutual Associations
132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan.
Tel: +81-45-891-2171; Fax: +81-45-895-8352
E-mail: nozue2493@yahoo.co.jp
Original Article
Impact of SYNTAX score on 1-year clinical outcomes in patients undergoing
percutaneous coronary intervention for unprotected left main coronary
artery
Tsuyoshi Nozue, Ryo Kamijima, Taku Iwaki, Ichiro Michishita
Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan; Division of
Cardiology, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
Received June 25, 2012; accepted July 19, 2012; Epub July 25, 2012; Published August 15, 2012
Abstract: SYNTAX score is an angiographic scoring system that was developed to quantify the number, complexity, and
location of lesions in patients undergoing coronary revascularization. Up to now, the impact of SYNTAX score on clinical
outcomes in patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery (LMCA)
lesions has not been fully examined. Therefore, we evaluate the usefulness of the SYNTAX score and identify the cutoff
point of this score to predict 1-year clinical outcomes in patients undergoing PCI for unprotected LMCA lesions. This was a
single-center retrospective study that included 49 consecutive patients undergoing elective PCI for unprotected LMCA
lesions. We calculated the SYNTAX score and examined the correlations between this score and 1-year clinical outcomes.
Major adverse cardiac events (MACE) occurred in 12 patients (24%): target lesion revascularization in 9 patients (18%),
myocardial infarction in 2 (4%), and cardiac death in 1 (2%). The frequency of MACE was significantly higher in the
intermediate (47%) or high score group (50%) than in the low score group (4%). Furthermore, the SYNTAX score was
significantly higher in the MACE group than in the non-MACE group (31 vs. 22, p = 0.008). Receiver-operating characteristic
curve showed that the SYNTAX score exhibited 83% sensitivity and 76% specificity for predicting the development of MACE
at a cutoff value 26. These results demonstrate that the SYNTAX score could be a useful tool to predict 1-year clinical
outcomes in patients undergoing elective PCI for unprotected LMCA lesions. (AJCD1206006).
Keywords: Coronary artery disease, left main coronary artery, percutaneous coronary intervention, SYNTAX score
Address all correspondence to:
Dr. Tsuyoshi Nozue
Division of Cardiology
Department of Internal Medicine
Yokohama Sakae Kyosai Hospital
Federation of National Public Service Personnel Mutual Associations
132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan.
Tel: +81-45-891-2171; Fax: +81-45-895-8352
E-mail: nozue2493@yahoo.co.jp
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