Background: Percutaneous mitral valve repair (PMVR) using the MitraClip™ system has become a valuable alternative in patients with severe mitral regurgitation (MR) and high surgical risk. We sought to evaluate the prognostic value of the SYNTAX II score (SSII) in patients with concomitant coronary artery disease (CAD) undergoing a Mitraclip procedure.
Methods: In seventy-five consecutive patients who underwent PMVR at the University Heart Center Zürich and the Cardiocentro Ticino, the SSSII was calculated at baseline. Clinical endpoints comprised of all-cause mortality, mitral valve surgery due to failure of PMVR or reoperation, hospitalization for congestive heart failure, heart transplantation and the composite of all four endpoints.
Results: Patients were followed for a median of 271days. And were divided in tertiles of SSII: SSII low ≤46.5 (n=25), SSII mid 46.6-54.4 (n=25) and SSII high ≥54.5 (n=25). Patients in the highest SSII tertile had a lower left ventricular ejection fraction (33% vs. 40% vs. 53%) with a higher log-BNP (3.6 vs. 3.45 vs. 3.16) when compared to SSII mid and SSII low, respectively. However, the anatomical syntax score (SS) did not differ significantly within the tertiles (9.1±6.3 (SSII Low) vs 9.5±7.6 (SSII Mid) vs 10.2±6.7(SSII High), p=0.837). The primary endpoint occurred in 33% of patients (n=25). By multivariate analysis patients in the high SSII tertile (OR=6.12, 95% confidence interval, [CI] 1.45-25.86, p=0.014) and patients with a history of MI (OR=3.57, 95% confidence interval, [CI] 1.17-10.88, p=0.025) were at significantly higher risk of experiencing adverse events. Furthermore, in a combined outcome ROC curve analysis, the SSII showed good discrimination with an AUC of 0.73, p=0.001. A cutoff SSII >49 has been identified to have a sensitivity of 83% and specificity of 53% with approximately 45% of the patients experiencing an event during follow-up.
Conclusion: Using SSII in CAD patients undergoing PMVR is feasible and of prognostic significance hence widening its clinical utility in valvular heart disease.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijcard.2017.02.049 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mitigating Medical Adverse Events Following Spinal Surgery: The Effectiveness of a Postoperative Quality Improvement (QI) Care Bundle.
Qual Manag Health Care
October 2024
Author Affiliations: Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. (Drs Moskven, Craig, Banaszek, Inglis, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, and Street, and Mrs Belanger,); Arthritis Research Canada, Richmond, British Columbia, Canada. (Dr Sayre), and Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada. (Drs Chittock, and Griesdale).
Article Synopsis
- Spine surgery often leads to postoperative medical adverse events (AEs), primarily minor ones, which can be costly and impact patient outcomes; a study aimed to assess the effectiveness of a quality improvement (QI) care bundle in reducing these events.
- The research spanned 14 years and compared outcomes before and after implementing the QI care bundle, analyzing nearly 13,500 patients to evaluate changes in AEs and associated costs.
- Results indicated a significant reduction in several types of AEs, such as cardiac and pulmonary issues, following QI implementation; however, some AEs, like delirium, did not show improvement.
Subtle echocardiographic markers of CAD: looking beyond the LV ejection fraction in stable angina patients.
Clin Res Cardiol
October 2024
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Background: A routine echocardiogram aims at identifying only regional wall motion abnormality (RWMA) or left ventricle diastolic dysfunction (LVDD) for coronary artery disease (CAD). When absent, a study is often labeled "normal." This creates an unmet need to identify and add subtle markers of CAD to the routine echocardiogram to increase the diagnostic yield.
View Article and Find Full Text PDFEvaluation of Inflammatory Markers in Predicting Coronary Complexity: Insights from the SYNTAX II Score in NSTEMI Patients.
J Clin Med
October 2024
Department of Physiology, Medical Specialization Training Center (TUSMER), Ankara 06230, Turkey.
Article Synopsis
- * A study involving 600 NSTEMI patients at Aktif International Hospital from January 2020 to January 2024 analyzed how socio-demographic factors and certain blood markers related to SS-II scores, dividing patients into low (≤ 22) and high (> 32) complexity groups.
- * Results indicated significant differences in various biochemical markers and ratios between the two groups, with factors like peripheral artery disease and specific blood markers being linked to high-risk NSTEMI. Logistic
Prognostic Value of Quantitative Flow Ratio Combined with SYNTAX Scores I/II in Multivessel Coronary Artery Disease: A Small-Sample, Single-Center Study.
Rev Cardiovasc Med
September 2024
Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 200040 Shanghai, China.
Article Synopsis
- A study investigated how the non-invasive Quantitative Flow Ratio (QFR) impacts risk stratification in patients with multivessel coronary disease by comparing it to traditional SYNTAX scores.
- The research involved 160 patients over a year, indicating that using Functional SYNTAX Scores (FSS and FSSII) resulted in a significant reduction of high-risk patients for major cardiovascular events.
- Findings suggest that FSSII is more effective than other scoring methods in predicting risks, leading to better identification of patients who are actually at lower cardiovascular risk.
Comparison of accuracy and speed between plaster casting, high-cost and low-cost 3D scanners to capture foot, ankle and lower leg morphology of children requiring ankle-foot orthoses.
J Foot Ankle Res
September 2024
University of Sydney School of Health Sciences & Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Article Synopsis
- Traditional plaster casting for ankle-foot orthosis (AFO) fabrication is effective but slow; 3D scanning is emerging as a faster alternative.
- A study compared the accuracy and speed of two 3D scanners: the high-cost Artec Eva and low-cost Structure Sensor II (SSII) using different scanning protocols on pediatric patients needing AFOs.
- Results showed both scanners provided accurate measurements (with SSII performing better) and were quicker than plaster casting, with the SSII 2-person method being the fastest at around 26 seconds.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!