SYNTAX评分和临床SYNTAX评分对冠心病患者接受经皮冠状动脉介入治疗后临床事件风险的预测价值

Predictive value of SYNTAX score and clinical SYNTAX score for the risk of clinical events of coronary heart disease patients after percutaneous coronary intervention

目的 评估SYNTAX评分（SXscore）和临床SYNTAX评分（CSS）对接受经皮冠状动脉介入治疗（PCI）术后15个月主要终点事件的预测价值。方法 共纳入547名接受择期PCI或直接PCI患者，记录病变SXscore和CSS评分，随访PCI术后终点事件发生情况，评估评分与事件的关系。结果 随访15个月，高、中、低SXscore三组主要不良心脑血管事件（MACCE）发生率分别为13.5%、6.8%及0.0%（P＜0.0001）。控制混杂因素后，多因素回归分析显示，SXscore（RR＝1.101，95%CI 1.070～1.134）及CSS（RR＝1.017，95%CI 1.009～1.022）均是MACCE事件的独立预测因子（均为P＜0.0001）。 结论 SXscore评分和CSS评分是冠心病患者接受PCI术后MACCE事件的独立预测因子。

Objective To evaluate the predictive value of SYNTAX score （SXscore） and clinical SYNTAX score （CCS） in the primary endpoint events of coronary heart disease patients in 15 months after percutaneous coronary intervention （PCI）. Methods A total of 547 patients undergoing selective or emergency PCI in our department from June 2009 to June 2011 were enrolled in this study. SXscore and CCS were carried out to grade the severity and extension of stenosis. The major adverse cardiac and cerebrovascular events （MACCE, including cardiac death, myocardial infarction, and revascularization and stroke from any cause）, the secondary endpoint events （including target lesion failure, such as cardiac death and target-vessel driven myocardial infarction, and ischemia-driven target lesion revascularization）, stent thrombosis, and hospitalization due to angina pectoris were observed during 15 months of follow-up by telephone or hospital visit. Results In the follow-up, the incidence of MACCE was 13.5%, 6.8% and 0.0%, respectively for those with high, medium and low scores in SXscore （P〈0.0001）. After multivariable adjustment, the SXscore （RR=1.101, 95%CI 1.070～1.134; P〈0.0001） and CSS （RR=1.017, 95%CI 1.009～1.022; P〈0.0001） were both identified as independent predictor of MACCE. Conclusion Both SXscore and CSS are independent predictor of MACCE for coronary heart disease patients after PCI.