Prognostic value of the SYNTAX score on myocardial injury and salvage in STEMI patients after primary percutaneous coronary intervention: a single-center retrospective observational study

BMC Cardiovascular Disorders

Lei Wang¹  Heping Niu¹  Jun Zhang¹  Guangren Gao¹  Jinguo Fu¹  Yi Li²  Lei Zhang³  Zhaoyang Huo³  Liqing Kang³  Lianrong Feng⁴ 

[1] Department of Cardiology, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China;Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China;Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China;Department of Neurology, Cangzhou Central Hospital, Tianjin Medical University, Tianjin, China;

关键词: ST-elevation myocardial infarction;    Percutaneous coronary intervention;    Coronary vessels;    Cardiac magnetic resonance;    Prognosis;    SYNTAX score;   

DOI  :  10.1186/s12872-021-02395-7

来源: Springer

【 摘 要 】

BackgroundSYNTAX score (SS) was shown to positively correlate with postprocedural myocardial injury in patients after elective coronary artery intervention, but evidence about the association of SS with myocardial salvage in ST-segment elevation myocardial infarction (STEMI) patients is still needed. This study aimed to evaluate the prognostic value of SS for myocardial injury and salvage assessed by cardiac magnetic resonance (CMR) after primary percutaneous coronary intervention (PCI) in STEMI patients.MethodsThis single-center retrospective study consecutively enrolled STEMI patients who had undergone primary PCI within 12 h from symptom onset. Both angiography and CMR were performed during hospitalization, and patients were divided into low SS (SS ≤ 22), mediate-high SS (SS > 22) groups. Correlation and multivariable analyses were performed.ResultsA total of 149 STEMI patients (96 low SS, 53 mediate-high SS) were included. In terms of myocardial injury parameters, there was a positive correlation (p < 0.001, Spearman r = 0.292) between SS and infarct size (IS), and a negative correlation (p < 0.001, Spearman r =  − 0.314) between SS and myocardial salvage index (MSI). In the multivariable model, SS (> 22 as categorical variable, OR = 2.245, 95% CI [1.002–5.053], p = 0.048; as continuous variable, OR = 1.053, 95% CI [1.014–1.095], p = 0.008) was significantly associated with high IS (≥ mean 35.43). The areas under the receiver operating characteristic (ROC) curves of SS for high IS and low MSI (≤ median 28.01) were 0.664 and 0.610.ConclusionsIn STEMI patients undergoing primary PCI, SYNTAX score positively correlated with infarct size and negatively with myocardial salvage, indicating an independent predictive value of the myocardial injury.

【 授权许可】

CC BY