Impact of Residual SYNTAX Score and Its Derived Indexes on Clinical Outcomes after Percutaneous Coronary Intervention：Data from a Large Single Center

Background： Residual SYNTAX score （rSS） and its derived indexes including SYNTAX revascularization index （SRI） and clinical rSS had been developed to quantify and describe the extent of incomplete revascularization. This study was conducted to explore the utility of the three scores among real-world patients alter percutaneous coronary intervention （PCI）. Methods： From January 2013 to December 2013, patients underwent PCI treatment at Fuwai Hospital were included. Tile primary endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events. The secondary endpoints were myocardial infarction, revascularization, stroke, and stent thrombosis. Kaptan-Meier methodology was used to determine the outcomes. Cox multivariable regression was to test the associations between scores and all-cause mortality. Results： A total of 10,344 patients were finally analyzed in this study. Kaplan-Meier survival analysis indicated that greater residual coronary lesions quantified by rSS and its derived indexes were associated with increased risk of adverse cardiovascular events. However, atier multivariate analysis, only clinical rSS was an independent predictor of 2-year all-cause death （hazard ratio： 1.02, 95% confidence interval： 1.01-1.03, P 〈 0.01）. By receiver operating characteristic （ROC） curve analysis, clinical rSS had superior predictability of 2-year all-cause death than rSS and SRI （area under ROC curve [AUC]： 0.50 vs. 0.56 vs. 0.56, all P 〈 0.01 ）, whereas rSS was superior in predicting repeat revascularization than clinical rSS and SRI （AUC： 0.62 vs. 0.61 vs. 0.61： all P 〈 0.01）. When comparing the predictive capability of rSS 〉8 with SRI 〈70%, their predictabilities were not significantly different.

Controversies on the Values for Health Instruments of Chinese Medicine

Currently, there are increasing debates on the necessity of health instruments in Chinese medicine（CM） emerging in China. This study aims to reevaluate its status and values. Analyzing the causes, limits, advantages, and properties characters of health instruments in CM, it is found that weak fundamental research, incomplete self-awareness, and complicated social factors are the primary causes of debates. A comprehensive analysis showed health instruments in CM have health evaluation benefits to people from a dominant Chinese culture, meet the requirements of cultural background, and bring long-term value to Chinese instrument researches. However, its values and status should be treated differently depending on various subtypes. Although little theoretical and practical evidences proved that patients-reported health instruments in CM should be proposed independently, the doctors- and nurses-reported questionnaires are necessary. With this in mind, the study group proposes the ＇Chinese cultural instruments（CCIs）＇ and ＇health-related CCIs＇. The latter one aims to evaluate the health status of people in a dominant Chinese culture. The CCIs theory represents Chinese instrument researches on a larger regional and higher level, and resolves the debates on instruments between CM and Western medicine in China. Health instruments in CM bring more scientific and social benefits for Chinese instrument researches. However, it does not include cultural demands, and lacks scientific significance. CCIs have all its virtues, and add solutions to the latter＇s theory bottleneck and scientific debates, thus bringing increased benefits to clinical assessment in complementary and alternative medicine researches.