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Published in: Clinical Research in Cardiology 7/2013

01-07-2013 | Original Paper

Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application

Published in: Clinical Research in Cardiology | Issue 7/2013

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Abstract

Background

Severity of coronary artery disease (CAD) is related to cardiovascular outcome. We aimed to assess the long-term follow-up depending on Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and Gensini score for prognosis. Both scores increase with complexity and thus reflect risk of cardiovascular events.

Methods and results

We determined complexity and extent of CAD by the SYNTAX and Gensini score in the AtheroGene cohort (N = 1,974, with 22.6 % women). The endpoint was non-fatal myocardial infarction (N = 132) and cardiovascular death (N = 159) over a median follow-up of 5.4 (Q1: 5.23/Q3: 5.57) years up to 8 years maximum (follow-up rate 99.4 %).
For SYNTAX score, the following distribution was used: low (≤22, N = 1,404), medium (23–32, N = 314), high score (>32, N = 256). Gensini score was split into thirds. Cox regression analysis showed a hazard ratio (HR) of 1.5 (95 % confidence interval 1.16–1.95; p = 0.0024) for the log transformed SYNTAX score in a fully adjusted model and a HR of 1.41 (95 % CI 1.13–1.77; p = 0.0025) for the Gensini score. The SYNTAX score alone had a C-index of 0.62, whereas adding clinical variables increased the C-index to 0.67. Similar results were obtained for the Gensini score. Regarding the SYNTAX score using net reclassification index, discrimination of events and non-events was enhanced by 37.2 % in a model of clinical variables and biomarkers and by 31.8 % for the Gensini score.

Conclusion

The SYNTAX and Gensini score in combination with clinical variables could be used to predict the cardiovascular prognosis during a long-term follow-up of up to 8 years in CAD patients.
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Metadata
Title
Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application
Publication date
01-07-2013
Published in
Clinical Research in Cardiology / Issue 7/2013
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-013-0555-4

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