Índice de revascularización SYNTAX y eventos cardiovasculares mayores en pacientes con enfermedad coronaria multiarterial en el Instituto Nacional de Cardiología Ignacio Chávez - México

Tania Vásquez Loarte; Yigal Piña Reyna; Marco Peña Duque; César Antonio Ortiz Zegarra

doi:10.47487/apcyccv.v4i1.282

Authors

Tania Vásquez Loarte Universidad de San Martín de Porras, Lima, Peru. https://orcid.org/0000-0002-8361-7668
Yigal Piña Reyna Instituto Nacional de Cardiología «Ignacio Chávez», Ciudad de Mexico, Mexico. https://orcid.org/0000-0003-3047-703X
Marco Peña Duque Instituto Nacional de Cardiología «Ignacio Chávez», Ciudad de Mexico, Mexico. https://orcid.org/0000-0002-7101-5280
César Antonio Ortiz Zegarra Instituto Nacional Cardiovascular INCOR. EsSalud, Lima, Peru. https://orcid.org/0000-0002-2549-3150

DOI:

https://doi.org/10.47487/apcyccv.v4i1.282

Keywords:

Myocardial Revascularization, Percutaneous Coronary Intervention, Coronary Artery Bypass, Coronary Disease

Abstract

Objective. To evaluate the degree of incomplete revascularization in patients with multiarterial coronary artery disease who underwent percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) using the Syntax revascularization index (SRI) and its relationship to major cardiovascular events during follow-up. Materials and Methods. Observational, retrospective study with 4-year follow-up of patients with multiarterial coronary artery disease who underwent surgical or percutaneous coronary revascularization, in whom the baseline Syntax score (SSb) and the residual
Syntax score (SSr) were calculated. The Syntax Revascularization Index (SRI) was determined with
the following formula: SRI = (1- [SSr/SSb]) x 100, and major cardiovascular events at 4-year follow-up were compared. Results. Two hundred patients (100 in each group) were evaluated. Mean SSr in group 1 was 83.2%, and in group 2, 79.0% (p=0.88). Mean complete revascularization was 41% in the first group and 35% in the second. A cutoff point of ≤90% of IRS had the best accuracy for predicting major cardiovascular events (area under the curve of 0.60; 95% CI: 0.49-0.71, p<0.05). In multivariate analysis IRS was an independent predictor of major cardiovascular events (HR 2.6; 95%CI: 1.32-3.22, p= 0.043). Conclusions. The Syntax Revascularization Index may be useful for measuring the degree of revascularization in patients with multiarterial coronary artery disease treated percutaneously or surgically. An SRI ≥90% may be an acceptable target for revascularization.

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