PMID- 25904244 OWN - NLM STAT- MEDLINE DCOM- 20170502 LR - 20181113 IS - 1615-2573 (Electronic) IS - 0910-8327 (Linking) VI - 31 IP - 6 DP - 2016 Jun TI - Incremental prognostic value of the SYNTAX score to late gadolinium-enhanced magnetic resonance images for patients with stable coronary artery disease. PG - 871-80 LID - 10.1007/s00380-015-0685-x [doi] AB - The prognostic significance of the SYNTAX (Synergy between PCI with Taxus and cardiac surgery) score has recently been demonstrated in patients with stable multivessel or left main coronary artery disease (CAD). The present study determines whether adding the SYNTAX score to Framingham risk score (FRS), left ventricular ejection fraction (LVEF) and presence of myocardial infarction (MI) by late gadolinium enhancement (LGE) magnetic resonance imaging can improve the risk stratification in patients with stable CAD. We calculated the SYNTAX score in 161 patients with stable CAD (mean age: 66 +/- 10 years old). During a mean follow-up of 2.3 years, 56 (35 %) of 161 patients developed cardiovascular events defined as cardiovascular death, non-fatal MI, cerebral infarction, unstable angina pectoris, hospitalization due to heart failure and revascularization. Multivariate Cox regression analysis selected triglycerides [hazard ratio (HR): 1.005 (95 % confidence interval (CI): 1.001-1.008), p < 0.008], presence of LGE [HR: 6.329 (95 % CI: 2.662-15.05), p < 0.001] and the SYNTAX score [HR: 1.085 (95 % CI: 1.044-1.127), p < 0.001] as risk factors for future cardiovascular events. Adding the SYNTAX score to FRS, EF and LGE significantly improved the net reclassification index (NRI) [40.4 % (95 % CI: 18.1-54.8 %), p < 0.05] with an increase in C-statistics of 0.089 (from 0.707 to 0.796). An increase in C-statistics and significant improvement of NRI showed that adding the SYNTAX score to the FRS, LVEF and LGE incrementally improved risk stratification in patient with stable CAD. FAU - Kato, Shingo AU - Kato S AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. shingo.m12226@gmail.com. FAU - Saito, Naka AU - Saito N AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Kirigaya, Hidekuni AU - Kirigaya H AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Gyotoku, Daiki AU - Gyotoku D AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Iinuma, Naoki AU - Iinuma N AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Kusakawa, Yuka AU - Kusakawa Y AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Iguchi, Kohei AU - Iguchi K AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Nakachi, Tatsuya AU - Nakachi T AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Fukui, Kazuki AU - Fukui K AD - Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan. FAU - Futaki, Masaaki AU - Futaki M AD - Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. FAU - Iwasawa, Tae AU - Iwasawa T AD - Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. FAU - Taguri, Masataka AU - Taguri M AD - Department of Biostatistics and Epidemiology, Yokohama City University, Yokohama, Japan. FAU - Kimura, Kazuo AU - Kimura K AD - Department of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. FAU - Umemura, Satoshi AU - Umemura S AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Hospital, Yokohama, Japan. LA - eng PT - Journal Article DEP - 20150423 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Triglycerides) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Aged MH - Angina, Unstable/etiology MH - Biomarkers/blood MH - Brain Infarction/etiology MH - Contrast Media/*administration & dosage MH - *Coronary Angiography MH - Coronary Artery Disease/complications/*diagnostic imaging/mortality/physiopathology MH - Disease Progression MH - Female MH - Gadolinium DTPA/*administration & dosage MH - Heart Failure/etiology MH - Hospitalization MH - Humans MH - Japan MH - Kaplan-Meier Estimate MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology MH - Predictive Value of Tests MH - Prognosis MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Factors MH - Stroke Volume MH - Time Factors MH - Triglycerides/blood MH - Ventricular Function, Left OTO - NOTNLM OT - Coronary artery disease OT - Late gadolinium enhancement OT - Magnetic resonance imaging OT - Prognosis OT - The SYNTAX score EDAT- 2015/04/24 06:00 MHDA- 2017/05/04 06:00 CRDT- 2015/04/24 06:00 PHST- 2015/02/16 00:00 [received] PHST- 2015/04/17 00:00 [accepted] PHST- 2015/04/24 06:00 [entrez] PHST- 2015/04/24 06:00 [pubmed] PHST- 2017/05/04 06:00 [medline] AID - 10.1007/s00380-015-0685-x [pii] AID - 10.1007/s00380-015-0685-x [doi] PST - ppublish SO - Heart Vessels. 2016 Jun;31(6):871-80. doi: 10.1007/s00380-015-0685-x. Epub 2015 Apr 23.