TY - JOUR
T1 - Assessment of the SYNTAX score in the syntax study
AU - Serruys, Patrick W.
AU - Onuma, Yoshinobu
AU - Garg, Scot
AU - Sarno, Giovanna
AU - van den Brand, Marcel
AU - Kappetein, Arie Pieter
AU - Van Dyck, Nic
AU - Mack, Michael
AU - Holmes, David
AU - Feldman, Ted
AU - Morice, Marie Claude
AU - Colombo, Antonio
AU - Bass, Eric
AU - Leadley, Katrin
AU - Dawkins, Keith D.
AU - van Es, Gerrit Anne
AU - Morel, Marie Angèle M.
AU - Mohr, Friedrich W.
PY - 2009
Y1 - 2009
N2 - Aims: The SYNTAX™ score has been designed to better anticipate the risks of percutaneous or surgical revascularisation, taking into account the functional impact of the coronary circulation with all its anatomic components including the presence of bifurcations, total occlusions, thrombus, calcification, and small vessels. The purpose of this paper is to describe the baseline assessment of the SYNTAX™ score in the Syntax randomised trial, the corelab reproducibility, the potential difference in score assessment between the investigator and the corelab, and to ascertain the impact on one-year outcome after either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) in patients with complex coronary artery disease. Methods and results: To assess the reliability of Syntax™ scoring, 100 diagnostic angiograms from the Syntax trial were randomly selected and assessed independently by two observers. Intra-observer variability was assessed by analysing 91 sets of angiograms after an interval of at least eight weeks by one of the observers. Clinical outcomes in the randomised cohort of the Syntax trial up to one year are presented with stratification by tertile group of the SYNTAX™ score. The weighted kappa value for the inter-observer reproducibility on the global score was 0.45, while the intra-observer weighted kappa value was 0.59. The SYNTAX™ score as calculated by investigators consistently underscored the corelab score by 3.4 points. When the Syntax randomised cohort was stratified by tertiles of the SYNTAX™ score, there were similar or non-significantly different MACCE rates in those with low or intermediate scores; however in the top tertile the MACCE rate was greater in those receiving PCI compared to CABG. Conclusions: The SYNTAX™ score is a visual coronary score with an acceptable corelab reproducibility that has an impact on the one-year outcome of those having PCI, whereas it has no effect on the one-year outcome following surgical revascularisation. The SYNTAX™ score tool is likely to be useful in a wide range of patients with complex coronary disease.
AB - Aims: The SYNTAX™ score has been designed to better anticipate the risks of percutaneous or surgical revascularisation, taking into account the functional impact of the coronary circulation with all its anatomic components including the presence of bifurcations, total occlusions, thrombus, calcification, and small vessels. The purpose of this paper is to describe the baseline assessment of the SYNTAX™ score in the Syntax randomised trial, the corelab reproducibility, the potential difference in score assessment between the investigator and the corelab, and to ascertain the impact on one-year outcome after either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) in patients with complex coronary artery disease. Methods and results: To assess the reliability of Syntax™ scoring, 100 diagnostic angiograms from the Syntax trial were randomly selected and assessed independently by two observers. Intra-observer variability was assessed by analysing 91 sets of angiograms after an interval of at least eight weeks by one of the observers. Clinical outcomes in the randomised cohort of the Syntax trial up to one year are presented with stratification by tertile group of the SYNTAX™ score. The weighted kappa value for the inter-observer reproducibility on the global score was 0.45, while the intra-observer weighted kappa value was 0.59. The SYNTAX™ score as calculated by investigators consistently underscored the corelab score by 3.4 points. When the Syntax randomised cohort was stratified by tertiles of the SYNTAX™ score, there were similar or non-significantly different MACCE rates in those with low or intermediate scores; however in the top tertile the MACCE rate was greater in those receiving PCI compared to CABG. Conclusions: The SYNTAX™ score is a visual coronary score with an acceptable corelab reproducibility that has an impact on the one-year outcome of those having PCI, whereas it has no effect on the one-year outcome following surgical revascularisation. The SYNTAX™ score tool is likely to be useful in a wide range of patients with complex coronary disease.
KW - Complex lesions
KW - Coronary artery bypass surgery
KW - Percutaneous coronary intervention
KW - SYNTAX score
KW - SYNTAX study
UR - http://www.scopus.com/inward/record.url?scp=70349335077&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349335077&partnerID=8YFLogxK
U2 - 10.4244/EIJV5I1A9
DO - 10.4244/EIJV5I1A9
M3 - Article
C2 - 19577983
AN - SCOPUS:70349335077
SN - 1774-024X
VL - 5
SP - 50
EP - 56
JO - EuroIntervention
JF - EuroIntervention
IS - 1
ER -