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EuroSCORE refines the predictive ability of SYNTAX score in patients undergoing left main percutaneous coronary intervention.
- Source :
-
American heart journal [Am Heart J] 2010 Jan; Vol. 159 (1), pp. 103-9. - Publication Year :
- 2010
-
Abstract
- Background: Whether SYNTAX score should be used as a stand-alone tool or whether its performance may be improved by the parallel use of clinical scores focusing on comorbidities, such as EuroSCORE, is a matter of debate.<br />Methods: A combined risk model including both clinical and angiographic information was developed, and its performance tested on a contemporary population of 255 patients with left main disease undergoing percutaneous coronary intervention (PCI). A global risk classification (GRC) system was created by combination of SYNTAX score and EuroSCORE strata, and new classes of risk were defined.<br />Results: When EuroSCORE was fitted into the SYNTAX score model, c-statistic increased from 0.681 to 0.732 for the prediction of cardiac mortality. The likelihood ratio test for the significance of adding the EuroSCORE term to the model was chi(2) = 4.109 (P = .043) with a net reclassification improvement of 26% (P = .002). GRC showed the best prediction and discriminative ability in terms of two-year cardiac mortality (HR 3.40, 95% CI 1.79-6.43, P < .001; c-statistic 0.756) as compared with SYNTAX score (HR 2.87, 95% CI 1.35-6.10, P = .006; c-statistic 0.747) and EuroSCORE (HR 3.04, 95% CI 1.41-6.57, P = .005; c-statistic 0.708) alone.<br />Conclusions: We found a significant improvement in the prediction of cardiac mortality with the inclusion of EuroSCORE in a SYNTAX score-based model. The degree of reclassification between treatment threshold categories indicates that clinical and angiographic information are both important for assessing individual risk of patients undergoing left main PCI.<br /> (Copyright 2010 Mosby, Inc. All rights reserved.)
- Subjects :
- Age Factors
Aged
Angioplasty, Balloon, Coronary mortality
Cohort Studies
Confidence Intervals
Coronary Angiography methods
Coronary Disease classification
Coronary Disease diagnostic imaging
Female
Humans
Italy
Kaplan-Meier Estimate
Male
Middle Aged
Predictive Value of Tests
Probability
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Sex Factors
Survival Analysis
Treatment Outcome
Angioplasty, Balloon, Coronary methods
Coronary Disease mortality
Coronary Disease therapy
Coronary Vessels pathology
Severity of Illness Index
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6744
- Volume :
- 159
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 20102874
- Full Text :
- https://doi.org/10.1016/j.ahj.2009.10.021