A multidirectional approach to risk assessment in patients with three-vessel coronary artery disease undergoing percutaneous intervention

Abstract Background The SYNTAX score (SS) and Clinical SYNTAX score (CSS) have demonstrated utility as risk-stratifying tools following percutaneous coronary intervention (PCI). However, useful determinants for predicting hard clinical events (HCE: death, nonfatal myocardial infarction, and stroke) in the setting of routinely-performed-angiographic follow-up have yet to be elucidated. Methods and results We retrospectively examined the clinical outcomes of 252 three-vessel disease (TVD) patients following PCI. The incidence of HCE at 3 years significantly differed according to CSS (High, 20.2%; Intermediate, 1.2%; and Low, 6.0%; log-rank p p  = 0.13). The incidence of repetitive revascularization at 3 years did not differ significantly both among SS (High, 45.2%; Intermediate, 36.5%; and Low, 38.2%; log-rank p  = 0.22) and CSS (High, 36.9%; Intermediate, 41.7%; and Low, 41.7%; log-rank p  = 0.88,). Conclusion Prediction of HCE in patients with TVD following PCI was more accurate with CSS than with SS.