Gökhan Demirci1, Serkan Aslan1, Ali Rıza Demir1, Begüm Uygur1, Ayan Işık1, Enes Arslan1, Mehmet Ertürk1

1Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul Health Sciences University, İstanbul, Türkiye

Keywords: Atherosclerosis; percutaneous coronary intervention

Abstract

Objectives: In this study, we aimed to investigate the relationship between the preprocedural logistic clinical SYNTAX score (Log CSS) and major cardiovascular events (MACE) in patients with true bifurcation lesion who underwent revascularization with the double stent strategy.

Patients and Methods: A total of 233 non ST elevation myocardial infarction (NSTEMI) patients who underwent revascularization with a double stent strategy between May 2011 and October 2019 were retrospectively included in the study. Anatomical SYNTAX score (SS) and log CSS were calculated. The patients were divided into two groups according to the cut-off value determined by ROC analysis. Patients with Log CSS> 6 were defined as high Log CSS group (n= 56) and those with Log CSS≤ 6 as low Log CSS group (n= 177). The prediction of 2-year MACE with Log CSS was evaluated.

Results: MACE developed in 33.9% of patients with high Log CSS and 8.5% of patients with low Log CSS (p< 0.001). In the Kaplan-Meier survival analysis, the long-term survival of high Log CSS patients was significantly lower than low Log CSS group (Log rank p< 0.001). In multivariate COX analyzes, high Log CCS (HR, 3.781; 95% CI, 1.706-8.377; p= 0.001) was the strongest independent predictor of MACE. Log CSS was more powerful in predicting two-year MACE development compared to anatomical SS.

Conclusion: Log CSS can be a simple and useful tool to predict the development of MACE in patients with true bifurcation lesion revascularized by percutaneous coronary intervention.