September 13th, 2010
Three-year SYNTAX Results: Sensible, Not Sensational
In SYNTAX, 1800 patients with multivessel and/or left main disease were randomized to CABG or PCI with DES after a surgeon and an interventional cardiologist reviewed the coronary angiogram and agreed that either procedure was appropriate. (See the CardioExchange News blog for more study information.)
The SYNTAX 3-year results show that patients with a low SYNTAX score have similar outcomes with PCI or CABG, whereas those with an intermediate or high score have a better outcome with CABG.
1) In the cohort as a whole, MACCE rates were higher for PCI than for CABG (28% vs 20%), mainly because of a higher rate of repeat revascularization in the PCI group.
a) Composite safety (death/stroke/MI) was similar in the PCI and CABG groups (14.1% and 12.0%, respectively)
b) MI incidence was nearly twice as high in PCI patients than in CABG patients (7.1% vs. 3.6%)
2) In patients with a low (0-22) SYNTAX score, MACCE rates were similar for PCI and CABG (22.7% and 22.5%, respectively)
3) In patients with an intermediate (23-32) or a high SYNTAX score, MACCE rates were higher with PCI than CABG (27.4% vs 18.9% for an intermediate score; 34.1% vs 19.5% for a high score)
Now be honest….do you calculate a SYNTAX score for your patients?
If you don’t, how do you determine which patients will do as well with PCI as with CABG?