Residual SYNTAX Score in Relation to Coronary Culprit Plaque Characteristics and Cardiovascular Risk in ST Segment Elevation Myocardial Infarction: an Intravascular Optical Coherence Tomography Study
- PMID: 34244969
- DOI: 10.1007/s12265-021-10152-6
Residual SYNTAX Score in Relation to Coronary Culprit Plaque Characteristics and Cardiovascular Risk in ST Segment Elevation Myocardial Infarction: an Intravascular Optical Coherence Tomography Study
Abstract
This study aimed to investigate the association of high-risk culprit plaque features by optical coherence tomography (OCT) with residual SYNTAX score (rSS) and the predictive value of rSS for major adverse cardiac events (MACE) in patients with ST segment elevation myocardial infarction (STEMI). We included 274 patients and divided them into 3 groups - rSS=0 (n=72), 0<rSS≤8 (n=134), and rSS>8 (n=68). There were significant differences in plaque characteristics among three groups (plaque rupture: 44.4% versus 59.0% versus 64.7%, lowest to highest rSS, p=0.040; OCT-defined high-risk plaques: 16.7% versus 23.9% versus 35.3%, lowest to highest rSS, p=0.036; calcification: 38.9% versus 52.5% versus 61.8%, lowest to highest rSS, p=0.024). During a mean follow-up of 2.2 years, MACE occurred in 47 (17.2%) patients; rSS >8 group had higher MACE risk compared to rSS=0 (HR: 2.68, 95%CI: 1.11-6.5, P=0.029). In conclusion, culprit plaque morphology was significantly correlated with rSS, and elevated rSS was associated with higher cardiovascular risk in STEMI patients. ClinicalTrials.gov : NCT03593928.
Keywords: Cardiovascular risk; Plaque rupture; Residual SYNTAX score; ST segment elevation myocardial infarction.
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
References
-
- Farooq, V., Serruys, P. W., Bourantas, C. V., et al. (2013). Quantification of incomplete revascularization and its association with five-year mortality in the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) trial validation of the residual SYNTAX score. Circulation, 128(2), 141–151. - DOI
-
- Song, Y., Gao, Z., Tang, X., et al. (2017). Impact of residual SYNTAX score on clinical outcomes after incomplete revascularisation percutaneous coronary intervention: a large single-centre study. EuroIntervention, 13(10), 1185–1193. - DOI
-
- Barthélémy, O., Rouanet, S., Brugier, D., et al. (2021). Predictive value of the residual SYNTAX score in patients with cardiogenic shock. Journal of the American College of Cardiology, 77(2), 144–155. - DOI
-
- Fujino, A., Kadohira, T., Redfors, B., et al. (2019). Significant association among residual SYNTAX score, non-culprit major adverse cardiac events, and greyscale and virtual histology intravascular ultrasound findings: a substudy from the PROSPECT study. EuroIntervention, 14(16), 1676–1684. - DOI
-
- Tearney, G. J., Regar, E., Akasaka, T., et al. (2012). Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. Journal of the American College of Cardiology, 59(12), 1058–1072. - DOI