Assessment of atherosclerotic lesions in coronary arteries using a modified SYNTAX score in patients with diabetes and acute coronary syndrome treated with coronary angioplasty and the prognosis
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 3
Abstract
<b>Introduction and aim.</b> An angiographic score assessing atherosclerotic lesions in coronary arteries, capturing number of lesions, their character, localization, functional influence and complexity may be a useful tool prognosing future cardiovascular episodes during short- and long-term observation of patients with diabetes treated by coronary angioplasty.<br><b>Material and methods.</b> A hospital database was analyzed in order to collect data in the years 2000-2005. From all patients with acute coronary syndrome (2664) hospitalized in tat time 233 (8.7%) were selected. Atherosclerotic lesions in coronary arteries were assessed using a modified SYNTAX score (SS). Demographic data: mean age 79.03 ± 3.44, proportion of males 131 (56.2%), STEMI 123 (52.7%), hypertension: 193 (82.8%), chronic kidney disease: 59 (25.3%), stroke: 21 (9%), dyslipidaemia: 181 (77.8%), smokers: 76 (32.6%), EF: 46.8 ± 10.7%, mean SYNTAX score: 23.15 ± 12.3. The patients were divided according to the presence of diabetes: with (114, 48.9%) or without this disease.<br><b>Results.</b> Diabetics are characterized by more advanced atherosclerotic lesions in comparison with those without diabetes (SYNTAX score: 28.5 ± 13.6 vs. 18.1 ± 8.1; p = 0.0001), especially when localized near big vessels (69.3% vs. 55.5%; p = 0.029). In a Cox proportional hazard regression it was shown that increase of the risk of early complications was associated with diabetes (HR 1.7; p = 0.04), coronary artery amputation (HR 4, p = 0.03) and higher SYNTAX score (HR 1.01; p = 0.049), increased risk of intrahospital complications was associated with higher SYNTAX score (HR 1.027; p = 0.01), and long-term prognosis was associated with the presence of coronary artery amputation (HR 4.19; p = 0.01).<br><b>Conclusions.</b> More advanced atherosclerotic lesions in coronary arteries in patients with acute coronary syndrome is associated with worse prognosis in short- and long-term observation.
Authors and Affiliations
Bernadetta Kałuża, Piotr Seweryniak, Tomasz Kulawik, Robert Gil, Edward Franek
Keywords
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