TY - JOUR
T1 - Residual SYNTAX II Score and long-term outcomes post-ST-elevation myocardial infarction in an urban US cohort
T2 - The Montefiore STEMI Registry
AU - Bortnick, Anna E.
AU - Shitole, Sanyog G.
AU - Hashim, Hayder
AU - Khullar, Pankaj
AU - Park, Michael
AU - Weinreich, Michael
AU - Seibert, Stephen
AU - Rauch, Judah
AU - Weisz, Giora
AU - Kizer, Jorge R.
N1 - Funding Information:
The Montefiore STEMI Registry was funded by the Department of Medicine, Division of Cardiology, Montefiore Health System. A.E.B. recognizes support from the Empire Clinical Research Program, an American Heart Association Mentored and Clinical Population Research Award (17MCPRP33630098), NIH/National Center for Advancing Translational Science (NCATS) Einstein-Montefiore CTSA Grant UL1TR001073 and K23 HL146982 from the National Heart, Lung, and Blood Institute (NHLBI). J.R.K. is supported by a K24 HL135493 from the NHLBI.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background Higher residual anatomic disease was associated with increased mortality in a recent randomized controlled trial of revascularization after ST-elevation myocardial infarction (STEMI). Less is known about the impact of residual disease post-STEMI in race-ethnic minorities. Methods Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX)- II (SS-II) score is an established scoring method for anatomic disease and prevalent co-morbidities to describe patient complexity. We evaluated residual (r) SS-II in 165 patients from a single center urban US registry (n = 1208) presenting for primary percutaneous coronary intervention of STEMI and treated for 3-vessel or left main and any combination of 0, 1, 2 or 3-vessel disease. Results The median age was 62 years (IQR 52-70), 29.1% women, 44.9% Hispanic/Latino and 19.4% non-Hispanic Black. Over median of 4.9 years (IQR 2.9-6.3), higher rSS-II was associated with increased death [hazard ratio 2.46 per SD increment in log rSS-II (∼five-fold increment on the original scale) 95% CI 1.51, 3.99], death or all-cause readmission (hazard ratio 1.37 per SD increment in log rSS-II 95% CI, 1.11-1.70) and death or cardiovascular disease readmission (hazard ratio 1.46 per SD increment in log rSS-II 95% CI, 1.14-1.88). rSS-II was higher in older women with more co-morbidities, but not different by race-ethnicity. Conclusions In summary, higher rSS-II was associated with long-term outcomes post-STEMI in a prospective urban, minority cohort, suggesting a potential role for risk stratification with this measure in a non-trial setting.
AB - Background Higher residual anatomic disease was associated with increased mortality in a recent randomized controlled trial of revascularization after ST-elevation myocardial infarction (STEMI). Less is known about the impact of residual disease post-STEMI in race-ethnic minorities. Methods Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX)- II (SS-II) score is an established scoring method for anatomic disease and prevalent co-morbidities to describe patient complexity. We evaluated residual (r) SS-II in 165 patients from a single center urban US registry (n = 1208) presenting for primary percutaneous coronary intervention of STEMI and treated for 3-vessel or left main and any combination of 0, 1, 2 or 3-vessel disease. Results The median age was 62 years (IQR 52-70), 29.1% women, 44.9% Hispanic/Latino and 19.4% non-Hispanic Black. Over median of 4.9 years (IQR 2.9-6.3), higher rSS-II was associated with increased death [hazard ratio 2.46 per SD increment in log rSS-II (∼five-fold increment on the original scale) 95% CI 1.51, 3.99], death or all-cause readmission (hazard ratio 1.37 per SD increment in log rSS-II 95% CI, 1.11-1.70) and death or cardiovascular disease readmission (hazard ratio 1.46 per SD increment in log rSS-II 95% CI, 1.14-1.88). rSS-II was higher in older women with more co-morbidities, but not different by race-ethnicity. Conclusions In summary, higher rSS-II was associated with long-term outcomes post-STEMI in a prospective urban, minority cohort, suggesting a potential role for risk stratification with this measure in a non-trial setting.
KW - acute coronary syndrome
KW - coronary artery disease
KW - myocardial infarction
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UR - http://www.scopus.com/inward/citedby.url?scp=85128245349&partnerID=8YFLogxK
U2 - 10.1097/MCA.0000000000001074
DO - 10.1097/MCA.0000000000001074
M3 - Article
C2 - 34049323
AN - SCOPUS:85128245349
VL - 33
SP - 206
EP - 212
JO - Coronary Artery Disease
JF - Coronary Artery Disease
SN - 0954-6928
IS - 3
ER -