Effect of Modified Global Risk Classification on  Prognosis at Patients Undergoing Bypass Surgery  and Percutaneous Coronary Intervention with  Multi-vessel Disease: Çoklu Damar Hastalığı Olan Baypas Cerrahisi ve Peruktan  Koroner Girişim Yapılan Hastalarda Modifiye Global Risk  Skorunun Prognoz Üzerindeki Etkisi

Onur Kaypaklı; Durmuş Yıldıray Şahin; Ali Deniz; Halil Aktaş; Rabia Eker Akıllı; Yahya Kemal İçen; Çağlar Emre Çağlayan; Mustafa Demirtaş

doi:10.5152/eurjther.2018.435

Authors

Onur Kaypaklı Department of Cardiology, Mustafa Kemal University School of Medicine, Hatay https://orcid.org/0000-0002-5065-3283
Durmuş Yıldıray Şahin Department of Cardiology, Health Sciences University, Adana Health Practices and Research Center, Adana https://orcid.org/0000-0002-3519-0962
Ali Deniz Department of Cardiology, Çukurova University School of Medicine, Adana https://orcid.org/0000-0003-1068-4277
Halil Aktaş Department of Cardiology, Çukurova University School of Medicine, Adana https://orcid.org/0000-0001-7229-1474
Rabia Eker Akıllı Department of Cardiology, Çukurova University School of Medicine, Adana https://orcid.org/0000-0003-4922-6556
Yahya Kemal İçen Department of Cardiology, Health Sciences University, Adana Health Practices and Research Center, Adana https://orcid.org/0000-0003-0070-5281
Çağlar Emre Çağlayan Department of Cardiology, Çukurova University School of Medicine, Adana https://orcid.org/0000-0003-1114-9014
Mustafa Demirtaş Department of Cardiology, Çukurova University School of Medicine, Adana https://orcid.org/0000-0003-3560-7489

DOI:

https://doi.org/10.5152/eurjther.2018.435

Keywords:

Modified global risk score, coronary artery bypass surgery, percutaneous transluminal coronary angioplasty

Abstract

Objective: The aim of this study was to compare mortality and myocardial infarction in patients with multi-vessel disease using“Modified Global Risk Classification” (mGRC).
Methods: We divided 579 patients into low, intermediate risk with a high EuroSCORE (IE), intermediate risk with a high SYNTAX score (IS), and high Modified Global Risk groups. Patients were evaluated for death, myocardial infarction, cerebrovascular events, need for re-intervention, and a primary endpoint, which denotes the occurrence of any one of the four events.
Results: Comparing the bypass surgery and percutaneous coronary intervention groups using mGRC showed significantly better prognostic results in the bypass surgery patients for the rate of the occurrence of the myocardial infarction for the IS group (p=0.047). In terms of the primary endpoint, the EuroSCORE, SYNTAX score, and Global Risk Classification (GRC) were found to be independent risk factors in logistic regression analysis. The ability of GRC to discriminate for the 1-year mortality was found to be better than that of the EuroSCORE and SYNTAX score.
Conclusion: With the evaluation of the EuroSCORE and SYNTAX score together, the modified GRC, which includes both anatomical and clinical risk factors, provides an additional benefit for predicting the prognosis and decision of treatment in patients with multi-vessel disease.

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