TY - JOUR
T1 - 10 Years of SYNTAX
T2 - Closing an Era of Clinical Research After Identifying New Outcome Determinants
AU - Serruys, Patrick W.
AU - Revaiah, Pruthvi C.
AU - Ninomiya, Kai
AU - Masuda, Shinichiro
AU - Kotoku, Nozomi
AU - Kageyama, Shigetaka
AU - Onuma, Yoshinobu
AU - Morel, Marie Angele
AU - Garg, Scot
AU - Feldman, Ted
AU - Kappetein, Arie Pieter
AU - Holmes, David R.
AU - Mack, Michael J.
AU - Mohr, Friedrich Wilhelm
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/6
Y1 - 2023/6
N2 - The SYNTAX trial randomized patients equally eligible for coronary artery bypass grafting or percutaneous coronary intervention using the Heart Team approach. The SYNTAXES study achieved a follow-up rate of 93.8% and reported the 10-year vital status. Factors associated with increased mortality at 10 years were pharmacologically treated diabetes mellitus, increased waist circumference, reduced left ventricular function, prior cerebrovascular and peripheral vascular disease, western Europe and North American descent, current smoking, chronic obstructive pulmonary disease, elevated C-reactive protein, anemia, and an increase in HbA1c. Procedural factors associated with higher 10 years mortality include periprocedural myocardial infarction, extensive stenting, small stents, ≥1 heavily calcified lesion, ≥1 bifurcation lesion, residual SYNTAX score >8, and staged percutaneous coronary intervention. Optimal medical therapy at 5 years, use of statins, on-pump coronary artery bypass grafting, multiple arterial grafts, and higher physical component score and mental component score were associated with lower mortality at 10 years. Numerous scores and prediction models were developed to help individualize risk assessment. Machine learning has emerged as a novel approach for developing risk models.
AB - The SYNTAX trial randomized patients equally eligible for coronary artery bypass grafting or percutaneous coronary intervention using the Heart Team approach. The SYNTAXES study achieved a follow-up rate of 93.8% and reported the 10-year vital status. Factors associated with increased mortality at 10 years were pharmacologically treated diabetes mellitus, increased waist circumference, reduced left ventricular function, prior cerebrovascular and peripheral vascular disease, western Europe and North American descent, current smoking, chronic obstructive pulmonary disease, elevated C-reactive protein, anemia, and an increase in HbA1c. Procedural factors associated with higher 10 years mortality include periprocedural myocardial infarction, extensive stenting, small stents, ≥1 heavily calcified lesion, ≥1 bifurcation lesion, residual SYNTAX score >8, and staged percutaneous coronary intervention. Optimal medical therapy at 5 years, use of statins, on-pump coronary artery bypass grafting, multiple arterial grafts, and higher physical component score and mental component score were associated with lower mortality at 10 years. Numerous scores and prediction models were developed to help individualize risk assessment. Machine learning has emerged as a novel approach for developing risk models.
KW - CABG
KW - PCI
KW - SYNTAX
KW - coronary artery bypass grafting
KW - machine learning
KW - percutaneous coronary intervention
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U2 - 10.1016/j.jacasi.2023.03.014
DO - 10.1016/j.jacasi.2023.03.014
M3 - Review article
AN - SCOPUS:85161648636
SN - 2772-3747
VL - 3
SP - 409
EP - 430
JO - JACC: Asia
JF - JACC: Asia
IS - 3
ER -