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Background: Recently, machine learning algorithms have identified preprocedural γ-glutamyl transferase (GGT) as a significant predictor of long-term mortality after coronary revascularization in the SYNTAX (Synergy Between PCI [Percutaneous Coronary Intervention] With Taxus and Cardiac Surgery) trial. The aim of the present study is to investigate the impact of preprocedural GGT on 10-year all-cause mortality in patients with complex coronary artery disease after revascularization.
Methods And Results: The SYNTAX trial was a randomized trial comparing PCI with coronary artery bypass grafting in 1800 patients with complex coronary artery disease.
Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgical revascularization.
Clin Res Cardiol
September 2023
Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), University Road, Galway, H91 TK33, Ireland.
Article Synopsis
- The SYNTAXES study examined the long-term effects of repeat revascularization (RR) on 10-year mortality in patients with three-vessel and/or left main coronary artery disease after PCI or CABG, following previous findings from the SYNTAX trial.
- A total of 330 patients (18.3%) underwent RR within 5 years, with those who had PCI initially showing a higher 10-year mortality risk compared to those who had CABG.
- Overall, RR within 5 years did not significantly impact 10-year mortality rates, indicating a need for further research in larger populations to clarify these results.
Impact of periprocedural major adverse events on 10-year mortality after revascularisation.
EuroIntervention
March 2023
Department of Cardiology, University of Galway, Galway, Ireland.
Article Synopsis
- * Non-fatal PMAE were found to be less common after PCI compared to CABG, but they significantly predicted mortality within the first year despite not impacting long-term outcomes.
- * Optimal medical therapy (OMT) may improve survival in patients experiencing non-fatal PMAE, particularly in the first year post-procedure, emphasizing the need for closer follow-up during this time.
Effect of Patient-Reported Preprocedural Physical and Mental Health on 10-Year Mortality After Percutaneous or Surgical Coronary Revascularization.
Circulation
October 2022
Department of Cardiology, National University of Ireland, Galway (M.O., P.W.S., H.K., C.G., H.H., M.L., R.W., N.O., Y.O.).
Article Synopsis
- The study focuses on how preprocedural physical and mental health impacts outcomes for patients with complex coronary artery disease undergoing either PCI or CABG, using data from the SYNTAXES trial.* -
- Higher scores in physical and mental health were linked to lower 10-year mortality rates; specifically, a 10-point increase in these scores reduced the risk of death significantly.* -
- Among patients with good health scores, CABG offered a better survival rate than PCI, while no significant differences in mortality were found for those with lower health scores.*
Mortality after multivessel revascularisation involving the proximal left anterior descending artery.
Heart
October 2022
Department of Cardiology, National University of Ireland Galway, Galway, Ireland
Objective: We sought to investigate whether long-term clinical outcomes differ following percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in patients with three-vessel disease (3VD) and lesions in the proximal left anterior descending artery (P-LAD).
Methods: This post-hoc analysis of the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) Extended Survival study included patients with 3VD who were classified according to the presence or absence of lesions located in the P-LAD. Ten-year all-cause death and 5-year major adverse cardiac or cerebrovascular events (MACCE) were assessed.
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