The Synergy Between PCI With TAXUS and Cardiac Surgery (SYNTAX) score is effective
in predicting clinical outcome after percutaneous coronary intervention (PCI). However,
its prediction ability is low because it reflects only the coronary characterization.
We assessed the predictive value of combining the ankle-brachial index (ABI) and SYNTAX
score to predict clinical outcomes after PCI. The ABI-SYNTAX score was calculated
for 1,197 patients recruited from the Shinshu Prospctive Multi-center Analysis for
Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention
(SHINANO) registry, a prospective, observational, multicenter cohort study in Japan.
The primary end points were major adverse cardiovascular and cerebrovascular events
(MACE; all-cause death, myocardial infarction, and stroke) in the first year after
PCI. The ABI-SYNTAX score was calculated by categorizing and summing up the ABI and
SYNTAX scores. ABI ≤0.49 was defined as 4, 0.5 to 0.69 as 3, 0.7 to 0.89 as 2, 0.9
to 1.09 as 1, and 1.1 to 1.5 as 0; an SYNTAX score ≤22 was defined as 0, 23 to 32
as 1, and ≥33 as 2. Patients were divided into low (0), moderate (1 to 2), and high
(3 to 6) groups. The MACE rate was significantly higher in the high ABI-SYNTAX score
group than in the lower 2 groups (low: 4.6% vs moderate: 7.0% vs high: 13.9%, p =
0.002). Multivariate regression analysis found that ABI-SYNTAX score independently
predicted MACE (hazards ratio 1.25, 95% confidence interval 1.02 to 1.52, p = 0.029).
The respective C-statistic for the ABI-SYNTAX and SYNTAX score for 1-year MACE was
0.60 and 0.55, respectively. In conclusion, combining the ABI and SYNTAX scores improved
the prediction of 1-year adverse ischemic events compared with the SYNTAX score alone.
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Article Info
Publication History
Published online: November 05, 2015
Accepted:
October 22,
2015
Received in revised form:
October 22,
2015
Received:
July 24,
2015
Footnotes
The study is registered at the clinical trials registration http://www.umin.ac.jp/ctr/index/htm/ (UMIN000001107).
See page 184 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
