Abstract
Background The extent of coronary disease affects clinical outcomes and may predict the effectiveness of coronary revascularization with either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score quantifies the extent of coronary disease. Objectives This study sought to determine whether SYNTAX scores predicted outcomes and the effectiveness of coronary revascularization compared with medical therapy in the BARI-2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial. Methods Baseline SYNTAX scores were retrospectively calculated for BARI-2D patients without prior revascularization (N = 1,550) by angiographic laboratory investigators masked to patient characteristics and outcomes. The primary outcome was major cardiovascular events (a composite of death, myocardial infarction, and stroke) over 5 years. Results A mid/high SYNTAX score (≥23) was associated with a higher risk of major cardiovascular events (hazard ratio: 1.36, confidence interval: 1.07 to 1.75, p = 0.01). Patients in the CABG stratum had significantly higher SYNTAX scores: 36% had mid/high SYNTAX scores compared with 13% in the PCI stratum (p < 0.001). Among patients with low SYNTAX scores (≤22), major cardiovascular events did not differ significantly between revascularization and medical therapy, either in the CABG stratum (26.1% vs. 29.9%, p = 0.41) or in the PCI stratum (17.8% vs. 19.2%, p = 0.84). Among patients with mid/high SYNTAX scores, however, major cardiovascular events were lower after revascularization than with medical therapy in the CABG stratum (15.3% vs. 30.3%, p = 0.02), but not in the PCI stratum (35.6% vs. 26.5%, p = 0.12). Conclusions Among patients with diabetes and stable ischemic heart disease, higher SYNTAX scores predict higher rates of major cardiovascular events and were associated with more favorable outcomes of revascularization compared with medical therapy among patients suitable for CABG.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 395-403 |
| Number of pages | 9 |
| Journal | Journal of the American College of Cardiology |
| Volume | 69 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 31 2017 |
Bibliographical note
Publisher Copyright:© 2017 American College of Cardiology Foundation
Keywords
- angiography
- coronary disease
- ischemia
- prognosis
- stents
- surgery
Fingerprint
Dive into the research topics of 'SYNTAX Score and Long-Term Outcomes: The BARI-2D Trial'. Together they form a unique fingerprint.Cite this
- APA
- Standard
- Harvard
- Vancouver
- Author
- BIBTEX
- RIS
In: Journal of the American College of Cardiology, Vol. 69, No. 4, 31.01.2017, p. 395-403.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - SYNTAX Score and Long-Term Outcomes
T2 - The BARI-2D Trial
AU - Ikeno, Fumiaki
AU - Brooks, Maria Mori
AU - Nakagawa, Kaori
AU - Kim, Min Kyu
AU - Kaneda, Hideaki
AU - Mitsutake, Yoshiaki
AU - Vlachos, Helen A.
AU - Schwartz, Leonard
AU - Frye, Robert L.
AU - Kelsey, Sheryl F.
AU - Waseda, Katsuhisa
AU - Hlatky, Mark A.
AU - Detre, Katherine M.
AU - Kelsey, Sheryl F.
AU - Brooks, Maria Mori
AU - Orchard, Trevor J.
AU - Thomas, Stephen B.
AU - Tyrrell, Kim Sutton
AU - Rana, Jamal S.
AU - Averbach, Frani
AU - MacGregor, Joan M.
AU - O'Neal, Scott M.
AU - Pitluga, Kathleen
AU - Sansing, Veronica
AU - Tranchine, Mary
AU - Crow, Sharon W.
AU - Bertolet, Marianne (Marnie)
AU - Hardison, Regina
AU - Kip, Kevin
AU - Lombardero, Manuel
AU - Lu, Jiang
AU - Janiszewski, Sue
AU - Protivnak, Darina
AU - Reiser, Sarah
AU - Barton, Stephen
AU - Guo, Ping
AU - Kushner, Yulia
AU - Michael, Owen
AU - Martin, Jeffrey P.
AU - Kania, Christopher
AU - Kania, Michael
AU - O'Donnell, Jeffrey
AU - Maxwell, Rae Ann
AU - Frye, Robert L.
AU - Goldberg, Suzanne
AU - Rosenberg, Yves
AU - Desvigne-Nickens, Patrice
AU - Ershow, Abby
AU - Gordon, David
AU - Paltoo, Dina
AU - Jones, Teresa L Z
AU - Hueb, Whady
AU - Ramires, José
AU - Lopes, Neuza
AU - Wajchenberg, Bernardo Léo
AU - Martinez, Eulogio E.
AU - Oliveira, Sergio A.
AU - Ribeiro, Expedito E.
AU - Perin, Marcos
AU - Betti, Roberto
AU - Schwartz, Leonard
AU - Steiner, George
AU - Barolet, Alan
AU - Groenewoud, Yolanda
AU - Mighton, Lisa
AU - Camelon, Kathy
AU - O'Rourke, Robert
AU - Blodgett, Janet
AU - Sako, Edward
AU - Nicastro, Judith
AU - Prescott, Robin
AU - Rihal, Charanjit
AU - Kennedy, Frank
AU - Barsness, Gregory
AU - Basu, Amanda
AU - Clavell, Alfredo
AU - Frye, Robert
AU - Holmes, David R.
AU - Lerman, Amir
AU - Mullaney, Charles
AU - Reeder, Guy
AU - Rizza, Robert
AU - Schaff, Hartzell
AU - Smith, Steven
AU - Somers, Virend
AU - Sundt, Thoralf
AU - Ting, Henry
AU - Wright, R. Scott
AU - Helgemoe, Pam
AU - Lesmeister, Diane
AU - Rolbiecki, Deborah
AU - Lepe-Montoya, Luis
AU - Escobedo, Jorge
AU - Barraza, Rafael
AU - Baleón, Rubén
AU - Campos, Arturo
AU - García, Paula
AU - Lezama, Carlos
AU - Miramontes, Carlos
AU - Ocampo, Salvador
AU - Peñafiel, Joaquín V.
AU - Valdespino, Aquiles
AU - Verdín, Raúl
AU - Albarrán, Héctor
AU - Ayala, Fernando
AU - Chávez, Eduardo
AU - Murillo, Héctor
AU - Buitrón, Luisa Virginia
AU - Rico-Verdin, Beatriz
AU - Angulo, Fabiola
AU - Adler, Dale
AU - Halle, Austin Arthur
AU - Ismail-Beigi, Faramarz
AU - Paranjape, Suvinay
AU - Mazzurco, Stacey
AU - Ridley, Karen
AU - Ramanathan, Kodangudi
AU - Solomon, Solomon
AU - Wall, Barry
AU - Weinman, Darryl
AU - Touchstone, Tammy
AU - Douglas, Lillie
AU - Bourassa, Martial
AU - Tardif, Jean Claude
AU - Chiasson, Jean Louis
AU - Lavoie, Marc Andre
AU - Rabasa-Lhoret, Rémi
AU - Langelier, Hélène
AU - Foucher, Suzy
AU - Trudel, Johanne
AU - Monrad, Scott
AU - Srinivas, Vankeepuram
AU - Zonszein, Joel
AU - Crandall, Jill
AU - Duffy, Helena
AU - Vartolomei, Eugen
AU - King, Spencer
AU - Jacobs, Carl
AU - Robertson, David
AU - Porter, Marty
AU - Eley, Melanie
AU - Nichols, Emmalee
AU - LaCorte, Jennifer
AU - Mock, Melinda
AU - Rogers, William
AU - Ovalle, Fernando
AU - Bell, David
AU - Misra, Vijay K.
AU - Hillegass, William B.
AU - Aqel, Raed
AU - Pierce, Penny
AU - Smith, Melanie
AU - Saag, Leah
AU - Vaughn, Ashley
AU - Smith, Dwight
AU - Grimes, Tiffany
AU - Rolli, Susan
AU - Hill, Roberta
AU - Barrett, Beth Dean
AU - Morehead, Clarinda
AU - Doss, Ken
AU - Davidson, Charles J.
AU - Molitch, Mark
AU - Beohar, Nirat
AU - Massaro, Elaine
AU - Goodreau, Lynne
AU - Arroyo, Fabiola
AU - Neužil, Petr
AU - Pavlickova, Lenka
AU - Stehlíková, Štĕpánka
AU - Benedik, Jaroslav
AU - Coling, Liz
AU - Davies, Richard
AU - Glover, Christopher
AU - LeMay, Michel
AU - Mesana, Thierry
AU - Ooi, Teik Chye
AU - Silverman, Mark
AU - Sorisky, Alexander
AU - Favreau, Colette
AU - McClinton, Susan
AU - Weiss, Melvin
AU - Weiss, Irene
AU - Saulle, Leo
AU - Kannam, Harichandra
AU - Kurylas, Joanne C.
AU - Vasi, Lorraine
AU - Douglas, John
AU - Ghazzal, Ziyad
AU - Sperling, Laurence
AU - King, Spencer
AU - Dayamani, Priya
AU - Gebhart, Suzanne
AU - Basu, Sabreena
AU - Helmy, Tarek
AU - Tangpricha, Vin
AU - Hyde, Pamela
AU - Jenkins, Margaret
AU - Grant, Barbara P.
AU - Kent, Kenneth
AU - Suddath, William
AU - Magee, Michelle
AU - Julien-Williams, Patricia
AU - Reed, Vida
AU - Nassar, Carine
AU - Dagenais, Gilles
AU - Garceau, Claude
AU - Auger, Dominique
AU - Buller, Christopher
AU - Elliott, Tom
AU - Ramanathan, Krishnan
AU - Ricci, Donald
AU - Fox, Rebecca
AU - Kolesniak, Daniela
AU - Attubato, Michael
AU - Feit, Frederick
AU - Richardson, Stephen
AU - Sing, Ivan Pena
AU - Slater, James
AU - Amendola, Angela
AU - Vargas, Bernardo
AU - Tsapatsaris, Nicholas
AU - Woods, Bartholomew
AU - Cushing, Gary
AU - Rutter, Martin
AU - Singh, Premranjan
AU - DesRochers, Gail
AU - Woodhead, Gail
AU - Gannon, Deborah
AU - Campbell, Nancy Shinopulos
AU - Ragosta, Michael
AU - Sarembock, Ian
AU - Powers, Eric
AU - Barrett, Eugene
AU - Jahn, Linda
AU - Murie, Karen
AU - Das, Gladwin
AU - Sigurdsson, Gardar
AU - White, Carl
AU - Bantle, John
AU - Redmon, J. Bruce
AU - Kwong, Christine
AU - Tamis-Holland, Jacqueline
AU - Albu, Jeanine
AU - Hochman, Judith S.
AU - Slater, James
AU - Wilentz, James
AU - Frances, Sylvaine
AU - Tormey, Deborah
AU - Pepine, Carl
AU - Smith, Karen
AU - Kennedy, Laurence
AU - Brezner, Karen
AU - Curry, Tempa
AU - Bleyer, Frank
AU - Albert, Stewart
AU - Mooradian, Arshag
AU - Plummer, Sharon
AU - Fuentes, Francisco
AU - Robles, Roberto
AU - Lavis, Victor
AU - Gomez, Jaime
AU - Iliescu, Cesar
AU - Underwood, Carol
AU - Fulton, Maria Selin
AU - Ramirez, Julie Gomez
AU - Merta, Jennifer
AU - Scott, Glenna
AU - Krishnaswami, Ashok
AU - Dowdell, Lynn
AU - Berkheimer, Sarah
AU - Greenbaum, Adam
AU - Whitehouse, Fred
AU - Pangilinan, Raquel
AU - Mann, Kelly
AU - Jacobs, Alice K.
AU - Sternthal, Elliot
AU - Ebner, Susana
AU - Nedeljkovic, Zoran
AU - Beardsley, Paula
AU - Schneider, David
AU - Pratley, Richard
AU - Cefalu, William
AU - Schnure, Joel
AU - Rowen, Michaelanne
AU - Tilton, Linda
AU - Niederman, Alan
AU - Mata, Cristina
AU - Kellerman, Terri
AU - Farmer, John
AU - Garber, Alan J.
AU - Kleiman, Neal
AU - Howard, Nancy
AU - Nichols, Debra
AU - Pool, Madonna
AU - Granger, Christopher
AU - Feinglos, Mark
AU - Adams, George
AU - Green, Jennifer
AU - Druken, Bernadette
AU - Underwood, Dani
AU - Stafford, J. Lawrence
AU - Donner, Thomas
AU - Laskey, Warren
AU - Beach, Dana
AU - Lopez, John
AU - Davis, Andrew
AU - Faxon, David
AU - Reutrakul, Sirimon
AU - Bayer, Emily
AU - Marroquin, Oscar
AU - Cohen, Howard
AU - Korytkowski, Mary
AU - Koerbel, Glory
AU - Baxendell, Lisa
AU - Rosenfelder, Debbie
AU - DeRiso, Louise
AU - Farrell, Carole
AU - Vita, Tina
AU - McGill, Janet
AU - Krone, Ronald
AU - Bach, Richard
AU - Recklein, Carol
AU - Luepke, Kristin M.
AU - Clifton, Mary Jane
AU - Farkouh, Michael E.
AU - Kim, Michael C.
AU - Smith, Donald A.
AU - Guzman, Ida
AU - Travis, Arlene
AU - O'Keefe, James
AU - Forker, Alan
AU - Isley, William
AU - Moe, Richard
AU - Kennedy, Paul
AU - Rosson, Margaret
AU - Long, Aimee
AU - Bates, Eric
AU - Herman, William
AU - Pop-Busui, Rodica
AU - Duvernoy, Claire
AU - Stevens, Martin
AU - Luciano, Ann
AU - Majors, Cheryl
AU - Gottlieb, Sheldon H.
AU - Rodriguez, Annabelle
AU - Herr, Melanie
AU - Williams, David
AU - Smith, Robert J.
AU - Abbott, J. Dawn
AU - Laufgraben, Marc J.
AU - Grogan, Mary
AU - Muratori, Janice
AU - Habib, Gabriel
AU - Marcelli, Marco
AU - Mikati, Issam
AU - Cordero, Emilia
AU - Caldwell, Gina
AU - Schechter, David
AU - Lorber, Daniel
AU - August, Phyllis
AU - Brown, Maisie
AU - Depree, Patricia
AU - Huber, Kurt
AU - Hanusch-Enserer, Ursula
AU - Jordanova, Nelly
AU - Cilesiz, Dilek
AU - Vogel, Birgit
AU - McCallister, Ben
AU - Kleerekoper, Michael
AU - Mandagere, Kelly
AU - Urbanic, Robert
AU - Bengston, James
AU - Kong, Bobby K.
AU - Pruitt, Andrew
AU - Sanfield, Jeffrey
AU - Carulli, Carol
AU - Churley-Strom, Ruth
AU - Magorien, Raymond
AU - Osei, Kwame
AU - Boyer, Cecilia Casey
AU - Lee, Richard
AU - Palumbo, Pasquale
AU - Wisbey, Joyce
AU - Alderman, Edwin
AU - Ikeno, Fumiaki
AU - Michael Steffes, Anne Schwarzkopf
AU - Nowicki, Maren
AU - Bucksa, Jean
AU - Chaitman, Bernard
AU - Eckstein, Jane
AU - Stocke, Karen
AU - Hlatky, Mark A.
AU - Boothroyd, Derek B.
AU - Melsop, Kathryn A.
AU - Sobel, Burton E.
AU - Rowen, Michaelanne
AU - Neimane, Dagnija
AU - Iskandrian, Ami E.
AU - Schaaf, Mary Beth
AU - Genuth, Saul
AU - Bongarno, Theresa
AU - Nesto, Richard
AU - August, Phyllis
AU - Hultberg, Karen
AU - Gottlieb, Sheldon H.
AU - Albu, Jeanine
AU - Rosenhouse-Romeo, Helene
AU - Orchard, Trevor J.
AU - Pambianco, Georgia
AU - Lombardero, Manuel
AU - Mock, Michael
AU - Frye, Robert L.
AU - Brooks, Maria Mori
AU - Desvigne-Nickens, Patrice
AU - Ershow, Abby
AU - Genuth, Saul
AU - Goldberg, Suzanne
AU - Gordon, David
AU - Hardison, Regina
AU - Jones, Teresa L Z
AU - Kelsey, Sheryl
AU - Nesto, Richard
AU - Orchard, Trevor
AU - Paltoo, Dina
AU - Rosenberg, Yves
AU - Ryan, Thomas
AU - Lebovitz, Harold
AU - Brown, Robert
AU - Friesinger, Gottlieb
AU - Horton, Edward
AU - Mason, Jay
AU - Virmani, Renu
AU - Wechsler, Lawrence
AU - Bairey-Merz, C. Noel
AU - Kennedy, J. Ward
AU - Gordon, David
AU - Antman, Elliott
AU - Colwell, John
AU - Fowler, Sarah
AU - Furberg, Curt
AU - Goldman, Lee
AU - Jennings, Bruce
AU - Rankin, Scott
N1 - Publisher Copyright: © 2017 American College of Cardiology Foundation
PY - 2017/1/31
Y1 - 2017/1/31
N2 - Background The extent of coronary disease affects clinical outcomes and may predict the effectiveness of coronary revascularization with either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score quantifies the extent of coronary disease. Objectives This study sought to determine whether SYNTAX scores predicted outcomes and the effectiveness of coronary revascularization compared with medical therapy in the BARI-2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial. Methods Baseline SYNTAX scores were retrospectively calculated for BARI-2D patients without prior revascularization (N = 1,550) by angiographic laboratory investigators masked to patient characteristics and outcomes. The primary outcome was major cardiovascular events (a composite of death, myocardial infarction, and stroke) over 5 years. Results A mid/high SYNTAX score (≥23) was associated with a higher risk of major cardiovascular events (hazard ratio: 1.36, confidence interval: 1.07 to 1.75, p = 0.01). Patients in the CABG stratum had significantly higher SYNTAX scores: 36% had mid/high SYNTAX scores compared with 13% in the PCI stratum (p < 0.001). Among patients with low SYNTAX scores (≤22), major cardiovascular events did not differ significantly between revascularization and medical therapy, either in the CABG stratum (26.1% vs. 29.9%, p = 0.41) or in the PCI stratum (17.8% vs. 19.2%, p = 0.84). Among patients with mid/high SYNTAX scores, however, major cardiovascular events were lower after revascularization than with medical therapy in the CABG stratum (15.3% vs. 30.3%, p = 0.02), but not in the PCI stratum (35.6% vs. 26.5%, p = 0.12). Conclusions Among patients with diabetes and stable ischemic heart disease, higher SYNTAX scores predict higher rates of major cardiovascular events and were associated with more favorable outcomes of revascularization compared with medical therapy among patients suitable for CABG.
AB - Background The extent of coronary disease affects clinical outcomes and may predict the effectiveness of coronary revascularization with either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score quantifies the extent of coronary disease. Objectives This study sought to determine whether SYNTAX scores predicted outcomes and the effectiveness of coronary revascularization compared with medical therapy in the BARI-2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial. Methods Baseline SYNTAX scores were retrospectively calculated for BARI-2D patients without prior revascularization (N = 1,550) by angiographic laboratory investigators masked to patient characteristics and outcomes. The primary outcome was major cardiovascular events (a composite of death, myocardial infarction, and stroke) over 5 years. Results A mid/high SYNTAX score (≥23) was associated with a higher risk of major cardiovascular events (hazard ratio: 1.36, confidence interval: 1.07 to 1.75, p = 0.01). Patients in the CABG stratum had significantly higher SYNTAX scores: 36% had mid/high SYNTAX scores compared with 13% in the PCI stratum (p < 0.001). Among patients with low SYNTAX scores (≤22), major cardiovascular events did not differ significantly between revascularization and medical therapy, either in the CABG stratum (26.1% vs. 29.9%, p = 0.41) or in the PCI stratum (17.8% vs. 19.2%, p = 0.84). Among patients with mid/high SYNTAX scores, however, major cardiovascular events were lower after revascularization than with medical therapy in the CABG stratum (15.3% vs. 30.3%, p = 0.02), but not in the PCI stratum (35.6% vs. 26.5%, p = 0.12). Conclusions Among patients with diabetes and stable ischemic heart disease, higher SYNTAX scores predict higher rates of major cardiovascular events and were associated with more favorable outcomes of revascularization compared with medical therapy among patients suitable for CABG.
KW - angiography
KW - coronary disease
KW - ischemia
KW - prognosis
KW - stents
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85010442916&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010442916&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2016.10.067
DO - 10.1016/j.jacc.2016.10.067
M3 - Article
C2 - 28126156
AN - SCOPUS:85010442916
SN - 0735-1097
VL - 69
SP - 395
EP - 403
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -