The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease
BackgroundSimple and effective risk models incorporating biomarkers associated with left main coronary artery (LMCA) stenosis are limited. This study aimed to validate the novel Bio-Clinical SYNTAX score (Bio-CSS) incorporating N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with L...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.912286/full |
| _version_ | 1811266237319086080 |
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| author | Jae Yong Yoon Jang Hoon Lee Jang Hoon Lee Hong Nyun Kim Hong Nyun Kim Namkyun Kim Namkyun Kim Se Yong Jang Se Yong Jang Myung Hwan Bae Myung Hwan Bae Dong Heon Yang Dong Heon Yang Hun Sik Park Hun Sik Park Yongkeun Cho Yongkeun Cho |
| author_facet | Jae Yong Yoon Jang Hoon Lee Jang Hoon Lee Hong Nyun Kim Hong Nyun Kim Namkyun Kim Namkyun Kim Se Yong Jang Se Yong Jang Myung Hwan Bae Myung Hwan Bae Dong Heon Yang Dong Heon Yang Hun Sik Park Hun Sik Park Yongkeun Cho Yongkeun Cho |
| author_sort | Jae Yong Yoon |
| collection | DOAJ |
| description | BackgroundSimple and effective risk models incorporating biomarkers associated with left main coronary artery (LMCA) stenosis are limited. This study aimed to validate the novel Bio-Clinical SYNTAX score (Bio-CSS) incorporating N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with LMCA stenosis.MethodsPatients who underwent percutaneous coronary intervention (PCI) for LMCA stenosis using a drug-eluting stent (n = 275) were included in the study. We developed the Bio-CSS incorporating NT-proBNP and validated the ability of the Bio-CSS to predict major adverse cardiac events (MACEs) and compared its performance to that of the SYNTAX score (SS) and SS II. The MACEs were defined as death, non-fatal myocardial infarction (MI), and repeat revascularizations.ResultsThe Bio-CSS (34.7 ± 18.3 vs. 51.9 ± 28.4, p < 0.001), as well as SS (23.6 ± 7.3 vs. 26.7 ± 8.1, p = 0.003) and SS II (29.4 ± 9.9 vs. 36.1 ± 12.8, p < 0.001), was significantly higher in patients with MACEs. In the Cox proportional hazards model, the log Bio-CSS (hazard ratio 8.31, 95% CI 1.84–37.55) was an independent prognostic factor for MACEs after adjusting for confounding variables. In the receiver operating characteristic curves, the area under the curve of the Bio-CSS was significantly higher compared to those of SS (0.608 vs. 0.706, p = 0.001) and SS II (0.655 vs. 0.706, p = 0.026). Patients were categorized into the three groups based on the tertiles of the Bio-CSS. Patients in the highest tertile of the Bio-CSS had significantly higher MACEs compared to those in the lower two tertiles (log-rank p < 0.001).ConclusionIn patients who underwent PCI for LMCA stenosis, the novel Bio-CSS improved the discrimination accuracy of established combined scores, such as SS and SS II. The addition of NT-proBNP to the clinical and angiographic findings in the Bio-CSS could potentially provide useful long-term prognostic information in these patients. |
| first_indexed | 2024-04-12T20:38:29Z |
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| id | doaj.art-a3f0257d230e4e569b990bc4978e45b2 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T20:38:29Z |
| publishDate | 2022-09-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-a3f0257d230e4e569b990bc4978e45b22022-12-22T03:17:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.912286912286The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery diseaseJae Yong Yoon0Jang Hoon Lee1Jang Hoon Lee2Hong Nyun Kim3Hong Nyun Kim4Namkyun Kim5Namkyun Kim6Se Yong Jang7Se Yong Jang8Myung Hwan Bae9Myung Hwan Bae10Dong Heon Yang11Dong Heon Yang12Hun Sik Park13Hun Sik Park14Yongkeun Cho15Yongkeun Cho16Department of Internal Medicine, CHA Gumi Medical Center, CHA University, Gumi, South KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, Daegu, South KoreaSchool of Medicine, Kyungpook National University, Daegu, South KoreaBackgroundSimple and effective risk models incorporating biomarkers associated with left main coronary artery (LMCA) stenosis are limited. This study aimed to validate the novel Bio-Clinical SYNTAX score (Bio-CSS) incorporating N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with LMCA stenosis.MethodsPatients who underwent percutaneous coronary intervention (PCI) for LMCA stenosis using a drug-eluting stent (n = 275) were included in the study. We developed the Bio-CSS incorporating NT-proBNP and validated the ability of the Bio-CSS to predict major adverse cardiac events (MACEs) and compared its performance to that of the SYNTAX score (SS) and SS II. The MACEs were defined as death, non-fatal myocardial infarction (MI), and repeat revascularizations.ResultsThe Bio-CSS (34.7 ± 18.3 vs. 51.9 ± 28.4, p < 0.001), as well as SS (23.6 ± 7.3 vs. 26.7 ± 8.1, p = 0.003) and SS II (29.4 ± 9.9 vs. 36.1 ± 12.8, p < 0.001), was significantly higher in patients with MACEs. In the Cox proportional hazards model, the log Bio-CSS (hazard ratio 8.31, 95% CI 1.84–37.55) was an independent prognostic factor for MACEs after adjusting for confounding variables. In the receiver operating characteristic curves, the area under the curve of the Bio-CSS was significantly higher compared to those of SS (0.608 vs. 0.706, p = 0.001) and SS II (0.655 vs. 0.706, p = 0.026). Patients were categorized into the three groups based on the tertiles of the Bio-CSS. Patients in the highest tertile of the Bio-CSS had significantly higher MACEs compared to those in the lower two tertiles (log-rank p < 0.001).ConclusionIn patients who underwent PCI for LMCA stenosis, the novel Bio-CSS improved the discrimination accuracy of established combined scores, such as SS and SS II. The addition of NT-proBNP to the clinical and angiographic findings in the Bio-CSS could potentially provide useful long-term prognostic information in these patients.https://www.frontiersin.org/articles/10.3389/fcvm.2022.912286/fullrisk stratificationN-terminal pro-B type natriuretic peptideleft main coronary artery diseasepercutaneous coronary interventiondrug eluting stent |
| spellingShingle | Jae Yong Yoon Jang Hoon Lee Jang Hoon Lee Hong Nyun Kim Hong Nyun Kim Namkyun Kim Namkyun Kim Se Yong Jang Se Yong Jang Myung Hwan Bae Myung Hwan Bae Dong Heon Yang Dong Heon Yang Hun Sik Park Hun Sik Park Yongkeun Cho Yongkeun Cho The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease Frontiers in Cardiovascular Medicine risk stratification N-terminal pro-B type natriuretic peptide left main coronary artery disease percutaneous coronary intervention drug eluting stent |
| title | The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease |
| title_full | The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease |
| title_fullStr | The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease |
| title_full_unstemmed | The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease |
| title_short | The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease |
| title_sort | novel bio syntax scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease |
| topic | risk stratification N-terminal pro-B type natriuretic peptide left main coronary artery disease percutaneous coronary intervention drug eluting stent |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.912286/full |
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