Age-dependent impact of the SYNTAX-score on longer-term mortality after percutaneous coronary intervention in an all-comer population
Madeleine Eickhoff
Stefanie Schüpke
Alexander Khandoga
Julia Fabian
Moritz Baquet
David Jochheim
David Grundmann
Manuela Thienel
Axel Bauer
Hans Theiss
Stefan Brunner
J(o)rg Hausleiter
Steffen Massberg
Julinda Mehilli
摘要：Background The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX)-score is a validated tool for risk stratification and revascularization strategy selection in patients with complex coronary artery disease.The aim of this study was to analyse its age-related prognostic value.Methods SYNTAX-score was calculated in 1331 all-comer patients undergoing percutaneous coronary intervention (PCI):463 patients ＞ 75 years and 868 patients ＜ 75 years.Outcomes of interest were all-cause mortality at one and two years.Results A significant interaction of age and SYNTAX-score for mortality was observed at two-year (Pinteraction =0.019) but not at one-year follow-up (Pinteraction=0.594).In multivariable analysis,SYNTAX-score independently predicted 1-year mortality in both age groups (＜ 75 years,hazard ratio (HR):1.43,95％ confidence intervals (CI):1.03-2.00,P =0.034;and ＞ 75 years,HR:1.37,95％ CI:1.01-1.85,P =0.042),but only two-year mortality among younger patients (＜ 75 years,HR:1.33,95％ CI:1.01-1.76,P =0.041;and ＞75 years,HR:1.11,95％ CI:0.87-1.41,P =0.394).SYNTAX-score tertiles were useful to stratity 1-year mortality in both,patients ＜ 75 years (SYNTAX-score ＜ 9,3.8％;9-20,5.3％;＞ 20,10.3％;P =0.004) and ＞ 75 years (SYNTAX-score ＜ 11,5.7％;11-22.5,16.1％;＞ 22.5,18.7％;P =0.003),but two-year mortality only among patients ＜ 75 years (SYNTAX-score ＜ 9,6.5％;9-20,7.6％;＞ 20,15％;P ＜ 0.001)and not among ＞ 75 years old patients (SYNTAX-score ＜ 11,19.4％;11-22.5,26.3％;＞ 22.5,27.9％;P =0.138).Conclusions Age modifies the impact of the SYNTAX-score on longer-term mortality after PCI.Among patients ＜ 75 years,the SYNTAX-score independently predicts the risk of death at one and two years after PCI,while among patients ＞ 75 years its predictive role is limited to the first year after PCI.Further studies are needed to evaluate the value of SYNTAX-score for selecting the most appropriate revascularization strategy among elderly patients.
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论文发表日期：2018-09-23
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 559-566 )
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