Prognostic impact of baseline and residual SYNTAX scores in cardiogenic shock

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Javanainen , T , Sans-Rosello , J , Harjola , V-P , Nieminen , M S , Lassus , J , Sionis , A , Varpula , M & Jurkko , R 2019 , ' Prognostic impact of baseline and residual SYNTAX scores in cardiogenic shock ' , Catheterization and Cardiovascular Interventions , vol. 93 , no. 1 , pp. 1-8 .

Title: Prognostic impact of baseline and residual SYNTAX scores in cardiogenic shock
Author: Javanainen, Tuija; Sans-Rosello, Jordi; Harjola, Veli-Pekka; Nieminen, Markku S.; Lassus, Johan; Sionis, Alessandro; Varpula, Marjut; Jurkko, Raija
Contributor: University of Helsinki, Department of Medicine
University of Helsinki, HUS Emergency Medicine and Services
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Kardiologian yksikkö
University of Helsinki, Kardiologian yksikkö
Date: 2019-01-01
Language: eng
Number of pages: 8
Belongs to series: Catheterization and Cardiovascular Interventions
ISSN: 1522-1946
Abstract: Objectives The aim was to assess the extent of coronary artery disease and revascularization using baseline SYNTAX Score (bSS) and residual SYNTAX Score (rSS) in patients with cardiogenic shock (CS) secondary to ST-segment elevation myocardial infarction (STEMI). The prognostic impact of SYNTAX Score (SS) was evaluated and assessed for additive value over clinical risk scores. Background bSS and rSS have been proven to be useful in risk stratification in stable coronary artery disease as well as in acute coronary syndromes, but they have not been studied in STEMI related CS. Methods Patients from a multinational prospective study of CS were analyzed. The study population was divided into tertiles according to bSS. The Cox regression and receiver operating characteristic (ROC) curves were used to assess the predictive power of SS. Results Of the 61 studied patients, 85% were male and the mean age was 67 years. Median bSS was 22 (15-32) and rSS 7 (0-13). Ninety-day mortality was 43%. bSS had negative prognostic value in multivariable analysis (HR 1.06, 95% CI 1.01-1.10). However, additive value over clinical risk scores was limited. rSS was not associated with mortality, whereas post-percutaneous coronary intervention (PCI) TIMI flow 3 of infarct-related artery (IRA) predicted better survival. Conclusions In STEMI related CS, the added value of bSS and rSS over clinical assessment and risk scores is limited. Our results suggest that while immediate PCI in order to restore blood flow to the IRA is essential, deferring the treatment of residual lesions does not seem to be associated with worse prognosis.
Subject: acute coronary syndrome
3121 General medicine, internal medicine and other clinical medicine

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