Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application
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Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application. / Sinning, Christoph; Lillpopp, Lars; Appelbaum, Sebastian; Ojeda, Francisco; Zeller, Tanja; Schnabel, Renate; Lubos, Edith; Jagodzinski, Annika; Keller, Till; Munzel, Thomas; Bickel, Christoph; Blankenberg, Stefan.
In: CLIN RES CARDIOL, Vol. 102, No. 7, 07.2013, p. 495-503.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application
AU - Sinning, Christoph
AU - Lillpopp, Lars
AU - Appelbaum, Sebastian
AU - Ojeda, Francisco
AU - Zeller, Tanja
AU - Schnabel, Renate
AU - Lubos, Edith
AU - Jagodzinski, Annika
AU - Keller, Till
AU - Munzel, Thomas
AU - Bickel, Christoph
AU - Blankenberg, Stefan
PY - 2013/7
Y1 - 2013/7
N2 - BACKGROUND: Severity of coronary artery disease (CAD) is related to cardiovascular outcome. We aimed to assess the long-term follow-up depending on Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and Gensini score for prognosis. Both scores increase with complexity and thus reflect risk of cardiovascular events.METHODS AND RESULTS: We determined complexity and extent of CAD by the SYNTAX and Gensini score in the AtheroGene cohort (N = 1,974, with 22.6 % women). The endpoint was non-fatal myocardial infarction (N = 132) and cardiovascular death (N = 159) over a median follow-up of 5.4 (Q1: 5.23/Q3: 5.57) years up to 8 years maximum (follow-up rate 99.4%). For SYNTAX score, the following distribution was used: low (≤22, N = 1,404), medium (23-32, N = 314), high score (>32, N = 256). Gensini score was split into thirds. Cox regression analysis showed a hazard ratio (HR) of 1.5 (95% confidence interval 1.16-1.95; p = 0.0024) for the log transformed SYNTAX score in a fully adjusted model and a HR of 1.41 (95% CI 1.13-1.77; p = 0.0025) for the Gensini score. The SYNTAX score alone had a C-index of 0.62, whereas adding clinical variables increased the C-index to 0.67. Similar results were obtained for the Gensini score. Regarding the SYNTAX score using net reclassification index, discrimination of events and non-events was enhanced by 37.2% in a model of clinical variables and biomarkers and by 31.8% for the Gensini score.CONCLUSION: The SYNTAX and Gensini score in combination with clinical variables could be used to predict the cardiovascular prognosis during a long-term follow-up of up to 8 years in CAD patients.
AB - BACKGROUND: Severity of coronary artery disease (CAD) is related to cardiovascular outcome. We aimed to assess the long-term follow-up depending on Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and Gensini score for prognosis. Both scores increase with complexity and thus reflect risk of cardiovascular events.METHODS AND RESULTS: We determined complexity and extent of CAD by the SYNTAX and Gensini score in the AtheroGene cohort (N = 1,974, with 22.6 % women). The endpoint was non-fatal myocardial infarction (N = 132) and cardiovascular death (N = 159) over a median follow-up of 5.4 (Q1: 5.23/Q3: 5.57) years up to 8 years maximum (follow-up rate 99.4%). For SYNTAX score, the following distribution was used: low (≤22, N = 1,404), medium (23-32, N = 314), high score (>32, N = 256). Gensini score was split into thirds. Cox regression analysis showed a hazard ratio (HR) of 1.5 (95% confidence interval 1.16-1.95; p = 0.0024) for the log transformed SYNTAX score in a fully adjusted model and a HR of 1.41 (95% CI 1.13-1.77; p = 0.0025) for the Gensini score. The SYNTAX score alone had a C-index of 0.62, whereas adding clinical variables increased the C-index to 0.67. Similar results were obtained for the Gensini score. Regarding the SYNTAX score using net reclassification index, discrimination of events and non-events was enhanced by 37.2% in a model of clinical variables and biomarkers and by 31.8% for the Gensini score.CONCLUSION: The SYNTAX and Gensini score in combination with clinical variables could be used to predict the cardiovascular prognosis during a long-term follow-up of up to 8 years in CAD patients.
KW - Aged
KW - Cohort Studies
KW - Coronary Angiography/methods
KW - Coronary Artery Disease/physiopathology
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/epidemiology
KW - Percutaneous Coronary Intervention/methods
KW - Prognosis
KW - Proportional Hazards Models
KW - Risk
KW - Risk Factors
KW - Severity of Illness Index
KW - Time Factors
U2 - 10.1007/s00392-013-0555-4
DO - 10.1007/s00392-013-0555-4
M3 - SCORING: Journal article
C2 - 23519584
VL - 102
SP - 495
EP - 503
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 7
ER -