Residual SYNTAX II Score and long-term outcomes post-ST-elevation myocardial infarction in an urban US cohort: the Montefiore STEMI Registry. Issue 3 (26th May 2021)

• Record Type: Journal Article
• Authors: Bortnick, Anna E.; Shitole, Sanyog G.; Hashim, Hayder; Khullar, Pankaj; Park, Michael; Weinreich, Michael; Seibert, Stephen; Rauch, Judah; Weisz, Giora; Kizer, Jorge R.
• Is Part Of: Coronary artery disease. Volume 33:Issue 3(2022)
• Page Start: 206
• Page End: 212
• Publication Date: 2021-05-26
• Subjects: acute coronary syndrome -- myocardial infarction -- coronary artery disease; Coronary heart disease -- Periodicals; Coronary Disease -- Indexes; Coronary Disease -- Periodicals; 616.123005
• DOI: 10.1097/MCA.0000000000001074
• Languages: English
• ISSNs: 0954-6928

Abstract

Abstract : 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.