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Functional SYNTAX score appears more accurate than classic SYNTAX score
Nam CW. J Am Coll Cardiol. 2011;58:1211-1218.
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Compared with the classic SYNTAX score, the functional SYNTAX score decreased the number of higher-risk patients and better discriminated risk for adverse events in patients with multivessel coronary artery disease undergoing percutaneous coronary intervention, according to a study.
In the Fractional Flow Reserve vs. Angiography for Multivessel Evaluation (FAME) study, patients were randomly assigned to angiography-guided PCI (n=497) or fractional flow reserve PCI (n=509). Angiographic guidance patients underwent stenting of all indicated lesions with drug-eluting stents, whereas in fractional flow reserve guidance patients, stents were only placed if fractional flow reserve measured in each diseased coronary artery was at least 0.80. The SYNTAX score was collected in 497 patients, and then the patients were divided into tertiles of risk based on low, medium and high SYNTAX score and functional SYNTAX score (FSS) groups. The primary outcome for the study was for each score to predict major adverse cardiac events at 1 year.
According to researchers, FSS determined a better predictive accuracy for major adverse cardiac events vs. SYNTAX score (P<.001). Major adverse cardiac events occurred in 9% of low FFS groups, 11.3% of medium FSS groups and 26.7% of high FSS groups (P<.001) vs. 8.4% in the low SYNTAX score groups, 10.2% in the medium SYNTAX score groups and 20.9% in the high SYNTAX score groups (P=.001). Repeat revascularization occurred in 4.5% of low FSS groups, 3.8% of medium FSS groups and 12.9% of high FSS groups (P=.005) vs. 3.6% of low SYNTAX score groups, 4.2% of medium SYNTAX score groups and 10.4% of high SYNTAX score groups (P=.02), according to the study.
Disclosure: Dr. Nam reports no relevant financial disclosures.
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