ABSTRACT

Objective - This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice.

Background - Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI.

Methods - We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013. Patients were stratified according to SS-II for PCI tertiles as follows: SS-II ≤ 20 (n = 1474); SS-II 20-26 (n = 1462); and SS-II > 26 (n = 1462). The predictive ability for 2-year mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.

Results - Mortality was significantly higher in the upper tertile than in the intermediate or lower tertiles during the 2-year follow-up (2.7% vs 1.7% vs 0.5%, respectively; P < 0.001). Multivariate analysis showed that SS-II was an independent predictor of 2-year mortality (hazard ratio: 1.66, 95% confidence interval: 1.03-2.68; P = 0.04). After adjusting for multivariable factors, SS-II had better prediction of 2-year mortality than baseline SS (C-index: SS-II = 0.740 vs baseline SS = 0.620; P < 0.001).

Conclusions - As a risk score combining both anatomical and clinical variables, SS-II demonstrated superiority compared with the purely angiographic SS to predict 2-year mortality in a clinical population of patients with severe CAD undergoing temporary PCI.