Coronary artery diseaseCyphering the Complexity of Coronary Artery Disease Using the Syntax Score to Predict Clinical Outcome in Patients With Three-Vessel Lumen Obstruction Undergoing Percutaneous Coronary Intervention
Section snippets
Study design and patient population
The ARTS II was a multicenter, nonrandomized, open-label, stratified, noninferiority trial designed to evaluate sirolimus-eluting stent (Cypher, Cordis, Warren, New Jersey) implantation in patients with multivessel disease using the surgical group of ARTS I as a historical control.7, 8 Inclusion and exclusion criteria for ARTS II have been previously reported.7, 8 Clopidogrel, 300 mg as a loading dose, or ticlopidine, administered at a dose of 500 mg, was started ≥24 hours before the procedure.
SXscore and baseline or procedural characteristics
Three hundred six patients and 1,292 lesions in total, with an average of 4.22 ± 1.2 lesions per patient, were analyzed. The overall SXscore in the studied population had an approximately normal distribution (p = 0.37) with a slight left skewness; it ranged from 4 to 54.5 with mean ± SD of 22.7 ± 8.6 (95% CI 21.8 to 23.7) and a median of 22 (interquartile range 16 to 28). In 4 patients, only 2 lesions were scored because the third treated lesion in each of these patients was judged to result in
Discussion
The identification of different distinct features associated with poor prognosis in patients with CAD has been a major breakthrough in modern medicine as an aid to allocate resources and as a tool to tailor intervention based on individual risk. Despite a continuous effort to detect new and progressively more sophisticated markers of prognosis in patients with CAD, implementation of unconventional and expensive risk stratification algorithms in the clinical setting remains problematic. Since
Acknowledgment
We acknowledge helpful suggestions and editorial comments by Brian Firth, MD.
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