Abstract
Abstract
Background
There is a paucity of evidence on the combination of the SYNTAX score II (SSII) and erythrocyte sedimentation rate (ESR) in assessing the long-term prognosis of patients with ST-elevated myocardial infarction (STEMI) and multivessel disease. The objective of this study was to investigate whether the ESR could enhance the predictive value of SSII on the long-term prognosis of STEMI patients.
Methods
A retrospective cohort study involving 483 STEMI and multivessel disease subjects receiving primary percutaneous coronary intervention was conducted. Major adverse cardiovascular events (MACE) included cardiovascular death, acute heart failure, recurrent myocardial infarction, revascularization, and nonfatal stroke. The predicted values of different models were estimated by a likelihood ratio test, Akaike’s information criteria (AIC), receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
Results
During the follow-up period of up to 52 months, both the SSII and ESR were independently associated with MACE (hazard ratio [HR] = 1.032, p < 0.001; and HR = 1.021, p < 0.001, respectively). The likelihood test indicated that ESR could improve the prognostic model containing SSII (p < 0.001), while the combined model of SSII and ESR attained a lower AIC (p < 0.001). The area under the ROC curve of the combined model containing SSII and ESR increased by 0.05 (p = 0.04) compared to that of the model with SSII alone. The net reclassification and integrated discrimination of the SSII alone model improved significantly with ESR (NRI = 0.0319, p < 0.001; IDI = 0.0334, p < 0.001).
Conclusions
The prognostic model containing SSII, which is an independent risk factor of MACE, had a significantly enhanced predictive probability with the addition of ESR.
Funder
National Natural Science Foundation of China
National Major Research Plan Training Program of China
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference33 articles.
1. Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, et al. 2014 ESC/EACTS guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35:2541–619.
2. Rencuzogullari I, Cagdas M, Karabag Y, Karakoyun S, Yesin M, Cinar T, et al. Value of syntax score II for predicting in-hospital and long-term survival in octogenarians with ST-segment elevation myocardial infarction: a comparison of six different risk scores. Arch Gerontol Geriatr. 2019;83:37–43.
3. Obeid S, Frangieh AH, Raber L, Yousif N, Gilhofer T, Yamaji K, et al. Prognostic value of SYNTAX score II in patients with acute coronary syndromes referred for invasive management: a subanalysis from the SPUM and COMFORTABLE AMI cohorts. Cardiology Res Pract. 2018;2018:9762176.
4. Cid-Alvarez AB, Gomez-Pena F, Redondo-Dieguez A, Avila A, Lopez D, Sanmartin X, et al. Prognostic impact of the SYNTAX score II in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: analysis of a four-year all-comers registry. EuroIntervention. 2019;15:e796–803.
5. Synetos A, Georgiopoulos G, Pylarinou V, Toutouzas K, Maniou K, Drakopoulou M, et al. Comparison of prognostic risk scores after successful primary percutaneous coronary intervention. Int J Cardiol. 2017;230:482–7.
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