Association of Preprocedural SYNTAX Score With Outcomes in Impella-Assisted High-Risk Percutaneous Coronary Intervention.

SYNTAX score high-risk percutaneous coronary intervention major adverse cardiovascular and cerebrovascular events outcomes

Journal

Journal of the Society for Cardiovascular Angiography & Interventions
ISSN: 2772-9303
Titre abrégé: J Soc Cardiovasc Angiogr Interv
Pays: United States
ID NLM: 9918419271306676

Informations de publication

Date de publication:
Aug 2024
Historique:
received: 26 12 2023
revised: 20 03 2024
accepted: 25 03 2024
medline: 21 8 2024
pubmed: 21 8 2024
entrez: 21 8 2024
Statut: epublish

Résumé

Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI). Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score-low (≤22), intermediate (23-32), and high (≥33). Procedural and clinical outcomes out to 90 days were compared between groups. Multivariable regression analysis was used to assess the impact of SYNTAX I score on major adverse cardiovascular and cerebrovascular events (MACCE) at 90 days. A total of 850 subjects with core laboratory-adjudicated SYNTAX I scores were identified (low: n = 310; intermediate: n = 256; high: n = 284). Patients with high SYNTAX I scores were older than those with low or intermediate SYNTAX I scores (72.7 vs 69.7 vs 70.1 years, respectively; A high SYNTAX I score was associated with higher rates of 90-day MACCE in patients who underwent Impella-assisted HRPCI. Further research is needed to understand the patient and procedural factors driving this finding.

Sections du résumé

Background UNASSIGNED
Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI).
Methods UNASSIGNED
Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score-low (≤22), intermediate (23-32), and high (≥33). Procedural and clinical outcomes out to 90 days were compared between groups. Multivariable regression analysis was used to assess the impact of SYNTAX I score on major adverse cardiovascular and cerebrovascular events (MACCE) at 90 days.
Results UNASSIGNED
A total of 850 subjects with core laboratory-adjudicated SYNTAX I scores were identified (low: n = 310; intermediate: n = 256; high: n = 284). Patients with high SYNTAX I scores were older than those with low or intermediate SYNTAX I scores (72.7 vs 69.7 vs 70.1 years, respectively;
Conclusions UNASSIGNED
A high SYNTAX I score was associated with higher rates of 90-day MACCE in patients who underwent Impella-assisted HRPCI. Further research is needed to understand the patient and procedural factors driving this finding.

Identifiants

pubmed: 39166169
doi: 10.1016/j.jscai.2024.101981
pii: S2772-9303(24)01052-4
pmc: PMC11330901
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101981

Informations de copyright

© 2024 The Author(s).

Auteurs

Giorgio A Medranda (GA)

Division of Cardiology, NYU Langone Hospital-Long Island, Mineola, New York.

Haroon A Faraz (HA)

Interventional Cardiology, Hackensack University Medical Center, Hackensack, New Jersey.

Julia B Thompson (JB)

Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.

Yiran Zhang (Y)

Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.

Aditya S Bharadwaj (AS)

Department of Cardiology, Loma Linda University Medical Center, Loma Linda, California.

Eric A Osborn (EA)

Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Arsalan Abu-Much (A)

Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.

Alexandra J Lansky (AJ)

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.

Mir B Basir (MB)

Division of Cardiology, Henry Ford Health System, Detroit, Michigan.

Jeffrey W Moses (JW)

Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
St. Francis Hospital & Heart Center, Roslyn, New York.

William W O'Neill (WW)

Division of Cardiology, Henry Ford Health System, Detroit, Michigan.

Cindy L Grines (CL)

Department of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, Georgia.

Suzanne J Baron (SJ)

Interventional Cardiovascular Research, Massachusetts General Hospital, Boston, Massachusetts.
Baim Institute for Clinical Research, Boston, Massachusetts.

Classifications MeSH