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
Abstract views: 35 / PDF downloads: 20
Keywords:Modified global risk score, coronary artery bypass surgery, percutaneous transluminal coronary angioplasty
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.
Seung KB, Park DW, Kim YH, Lee SW, Lee CW, Hong MK et al. Stents versus coronary-artery bypass grafting for left main coronary artery disease. N Engl J Med 2008; 358:1781-92.
Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg 1999; 16: 9-13.
Gogbashian A, Sedrakyan A, Treasure T. EuroSCORE: a systematic review of international performance. Eur J Cardiothorac Surg 2004; 25: 695-700.
Romagnoli E, Burzotta F, Trani C, Siviglia M, Biondi-Zoccai GG, Niccoli G et al. EuroSCORE as predictor of in-hospital mortality after percutaneous coronary intervention. Heart 2009; 95: 43-8.
Galassi AR, Colombo A, Buchbinder M, Grasso C, Tomasello SD, Ussia GP, Tamburino C. Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the “mini crush technique.” Catheter Cardiovasc Interv 2007; 69: 976-83.
Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. Eurointervention 2005; 1: 219-27.
Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009; 360: 961-72.
Serruys PW, Onuma Y, Garg S, Sarno G, van den Brand M, Kappetein AP et al. Assessment of the SYNTAX score in the Syntax study. EuroIntervention 2009; 5: 50-6.
SYNTAX score calculator: SYNTAX working-group. Available at: http://www.syntaxscore.com. Accessed April 1, 2012.
Garg S, Sarno G, Garcia-Garcia HM, Girasis C, Wykrzykowska J, Dawkins KD et al. A new tool for the Risk Stratification of Patients With Complex Coronary Artery Disease, the Clinical SYNTAX Score. Circ Cardiovasc Interv 2010; 3: 317-26.
Capodanno D, Miano M, Cincotta G, Caggegi A, Ruperto C, Bucalo R et al. EuroSCORE refines the predictive ability of SYNTAX score in patients undergoing left main percutaneous coronary intervention. Am Heart J 2010; 159: 103-9.
Serruys PW, Farooq V, Vranckx P, Girasis C, Brugaletta S, Garcia-Garcia HM et al. A Global Risk Approach to Identify Patients With Left Main or 3-Vessel Disease Who Could Safely and Efficaciously Be Treated With Percutaneous Coronary Intervention. JACC: Cardiovascular Interventions 2012; 5: 606-17.
How to Cite
Copyright (c) 2023 European Journal of Therapeutics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.