Residual SYNTAX Score and Survival Following Coronary Artery Bypass Grafting: Analysis of 1608 Patients

Introduction: We and others have previously shown that SYNTAX score predicts outcome in patients undergoing coronary artery bypass grafting (CABG). More recently, the residual SYNTAX score (rSS) has emerged as a reliable tool to quantify the extent and complexity of untreated coronary lesions after percutaneous coronary intervention (PCI). Indeed, rSS is an independent predictor of morbidity and mortality following PCI. Whether rSS may help to stratify mortality risk after CABG remains largely unknown. Hypothesis: The present study was designed to investigate the predictive value of rSS on mortality risk in a prospective cohort of patients undergoing surgical revascularization. Methods: Average baseline SYNTAX score calculated on 1608 patients (mean age 68±6 years, F:M 213:1395) undergoing isolated first-time CABG was 26.6 ± 9.4. The rSS measured after CABG was 3.2 ± 1.8 (p<0.001 vs baseline). Complete revascularization was assumed as rSS=0. Based on rSS tertiles, the study population was stratified in low rSS (08). Results: Following CABG, 1157/1608 (71.9%) patients had rSS=0, whereas 209/1608 (12.9%) had low rSS, 176/1608 (10.9%) had intermediate rSS and 66/1608 (4.1%) had high rSS. At Kaplan-Meier analysis of survival subjects in the highest rSS tertile (rSS>8) showed significant worse survival as compared to patients with rSS=0, 0更多