CAJ | 학술논문

Background:The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery Score Ⅱ (SS-Ⅱ) can well predict 4-year mortality in patients with complex coronary artery disease (CAD),and guide decision-making between coronary artery bypass graft surgery and percutaneous coronary intervention (PCI).However,there is lack of data regarding the utility of the SS-Ⅱ in patients with three-vessel CAD undergoing PCI treated with second-generation drug-eluting stents (DES).The purpose of the present study was to evaluate the ability of the SS-Ⅱ to predict long-term mortality in patients with three-vessel CAD undergoing PCI with second-generation DES.Methods:Totally,573 consecutive patients with de novo three-vessel CAD who underwent PCI with second-generation DES were retrospectively studied.According to the tertiles of the SS-Ⅱ,the patients were divided into three groups:The lowest SS-Ⅱ tertile (SS-Ⅱ ≤20),intermediate SS-Ⅱ tertile (SS-Ⅱ of 21-31),and the highest SS-Ⅱ tertile (SS-Ⅱ ≥32).The survival curves of the different groups were estimated by the Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the relationship between the SS-Ⅱ and 5-year mortality.The performance of the SS-Ⅱ with respect to predicting the rate of mortality was studied by calculating the area under the receiver operator characteristic (ROC) curve.The predictive ability of the SS-Ⅱ for 5-year mortality was evaluated and compared with the SS alone.Results:The overall SS-Ⅱ was 27.6 ± 9.0.Among patients in the lowest,intermediate and the highest SS-Ⅱ tertiles,the 5-year rates of mortality were 1.6％,3.2％,and 8.6％,respectively (P =0.003);the cardiac mortality rates were 0.5％,1.9％,and 5.2％,respectively (P =0.014).By multivariable analysis,adjusting for the potential confounders,the SS-Ⅱ was an independent predictor of 5-year mortality (hazard ratio:2.45,95％ confidence interval:1.38-4.36;P=0.002).The SS-Ⅱ demonstrated a higher predictive accuracy for 5-year mortality compared with the SS alone (the area under the ROC curve was 0.705 and 0.598,respectively).Conclusion:The SS-Ⅱ is an independent predictor of 5-year mortality in patients with three-vessel CAD undergoing PCI treated with second-generation DES,and demonstrates a superior predictive ability over the SS alone.