Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX…
Coronary Bifurcation Lesions: MRS or PCI? 10-Year Mortality of the SYNTAX Study
Percutaneous treatment of coronary lesions affecting bifurcations has increased in recent decades. Coronary angioplasty (percutaneous coronary intervention, PCI) in these cases is associated with an increased rate of adverse events in patients with multivessel disease and left main coronary artery lesions. The SYNTAX score, which is a predictor of total mortality, is used to evaluate…
ESC 2019 | SYNTAXES: Ten-Year Outcomes!
The SYNTAXES (SYNTAX Extended Survival) was presented at ESC 2019 with somewhat unexpected results in favor of PCI. This is why the SYNTAX continues to be one of the best studies interventional cardiologists can rely on. The original SYNTAX tested mortality (primary end point) with PCI vs. CABG in patients with multivessel and/or left main…
Angiography-Derived FFR: Complicated Software or Imminent Reality?
Angiography-derived fractional flow reserve (FFR) demonstrated substantial usefulness, especially in patients with three-vessel lesions. The functional SYNTAX score derived from angiography has the potential to redefine prognosis and treatment strategies compared with the classic anatomical SYNTAX score. This study sought to investigate the applicability of this method in patients with multivessel lesions included in the…
TCT 2018 | SYNTAXES: 10 Year Follow Up is ‘Trendy’
The SYNTAX trial had a 5-year follow-up, but the SYNTAXES (“ES” for extended survival) was specifically designed to find out comparative mortality of both treatments (PCI or surgery) at 10 years in patients with three vessel and/or left main lesions. This study retrospectively compared survival data at long term of 897 patients randomized to surgery…
SYNTAX II: Better Stents, IVUS, FFR, or a Combination of All of Them to Catch Up with Surgery
In patients with 3-vessel disease, surgery obtained better outcomes than angioplasty, according to results from the SYNTAX and FREEDOM trials, which used first-generation drug-eluting stents. Even in the BEST trial, which used new-generation stents, surgery still offered far better outcomes. Nobody is surprised by the fact that, whenever angioplasty evolves due to a new device…