Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction
No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow. We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culp...
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| Veröffentlicht in: | Arquivos brasileiros de cardiologia 2021-03, Vol.116 (3), p.466-472 |
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| container_title | Arquivos brasileiros de cardiologia |
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| creator | Matos, Luís Carlos V Carvalho, Luiz Sergio Modolo, Rodrigo Santos, Simone Silva, José Carlos Quinaglia E Almeida, Osório Luis Rangel de Sposito, Andrei C |
| description | No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow.
We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow.
In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade |
| doi_str_mv | 10.36660/abc.20200045 |
| format | Article |
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We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow.
In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5).
A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001).
Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).]]></description><identifier>EISSN: 1678-4170</identifier><identifier>DOI: 10.36660/abc.20200045</identifier><identifier>PMID: 33656051</identifier><language>eng</language><publisher>Brazil</publisher><subject>Aged ; Coronary Angiography ; Humans ; Middle Aged ; Myocardial Infarction - diagnostic imaging ; No-Reflow Phenomenon - diagnostic imaging ; Percutaneous Coronary Intervention ; Prospective Studies ; ST Elevation Myocardial Infarction - diagnostic imaging ; ST Elevation Myocardial Infarction - surgery ; Thrombosis ; Treatment Outcome</subject><ispartof>Arquivos brasileiros de cardiologia, 2021-03, Vol.116 (3), p.466-472</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-9835-1906 ; 0000-0001-8488-7662 ; 0000-0001-7127-2052</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33656051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matos, Luís Carlos V</creatorcontrib><creatorcontrib>Carvalho, Luiz Sergio</creatorcontrib><creatorcontrib>Modolo, Rodrigo</creatorcontrib><creatorcontrib>Santos, Simone</creatorcontrib><creatorcontrib>Silva, José Carlos Quinaglia E</creatorcontrib><creatorcontrib>Almeida, Osório Luis Rangel de</creatorcontrib><creatorcontrib>Sposito, Andrei C</creatorcontrib><title>Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction</title><title>Arquivos brasileiros de cardiologia</title><addtitle>Arq Bras Cardiol</addtitle><description><![CDATA[No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow.
We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow.
In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5).
A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001).
Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).]]></description><subject>Aged</subject><subject>Coronary Angiography</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>No-Reflow Phenomenon - diagnostic imaging</subject><subject>Percutaneous Coronary Intervention</subject><subject>Prospective Studies</subject><subject>ST Elevation Myocardial Infarction - diagnostic imaging</subject><subject>ST Elevation Myocardial Infarction - surgery</subject><subject>Thrombosis</subject><subject>Treatment Outcome</subject><issn>1678-4170</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo10D1PwzAYBGALCdFSGFmRR5YUf6cZS4FSqRREC4IpcuzXNCixi5OAOvDfqUSZbnnuhkPojJIhV0qRS12YISOMECLkAepTlY4SQVPSQ8dN80EIYymXR6jHuZKKSNpHP1PwTelLvDQhAtbe4tU6hrroGnzVRQsej63FjxFsadryC_CLrjrAbcDtGvDybbEav-7LpcfX0MKO-Xe8CMkTuCp8Y-1aiPh-G4yOttQVnnmn404Ff4IOna4aON3nAD3f3qwmd8n8YTqbjOfJhlHaJtpqpbLMGVakhmUMCmUIkbpgmbUMUilGqZSCC0t0ajixEqzjxhWOK6vUiA_Qxd_uJobPDpo2r8vGQFVpD6FrciYyxYSggu7o-Z52RQ0238Sy1nGb_1_GfwFYL2w1</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Matos, Luís Carlos V</creator><creator>Carvalho, Luiz Sergio</creator><creator>Modolo, Rodrigo</creator><creator>Santos, Simone</creator><creator>Silva, José Carlos Quinaglia E</creator><creator>Almeida, Osório Luis Rangel de</creator><creator>Sposito, Andrei C</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9835-1906</orcidid><orcidid>https://orcid.org/0000-0001-8488-7662</orcidid><orcidid>https://orcid.org/0000-0001-7127-2052</orcidid></search><sort><creationdate>20210301</creationdate><title>Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction</title><author>Matos, Luís Carlos V ; Carvalho, Luiz Sergio ; Modolo, Rodrigo ; Santos, Simone ; Silva, José Carlos Quinaglia E ; Almeida, Osório Luis Rangel de ; Sposito, Andrei C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-ada6699fc2b7c292eb6c005ab29dd2e7548755434d0a7c30d5edf3cfbf36d6683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Coronary Angiography</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>No-Reflow Phenomenon - diagnostic imaging</topic><topic>Percutaneous Coronary Intervention</topic><topic>Prospective Studies</topic><topic>ST Elevation Myocardial Infarction - diagnostic imaging</topic><topic>ST Elevation Myocardial Infarction - surgery</topic><topic>Thrombosis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matos, Luís Carlos V</creatorcontrib><creatorcontrib>Carvalho, Luiz Sergio</creatorcontrib><creatorcontrib>Modolo, Rodrigo</creatorcontrib><creatorcontrib>Santos, Simone</creatorcontrib><creatorcontrib>Silva, José Carlos Quinaglia E</creatorcontrib><creatorcontrib>Almeida, Osório Luis Rangel de</creatorcontrib><creatorcontrib>Sposito, Andrei C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Arquivos brasileiros de cardiologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matos, Luís Carlos V</au><au>Carvalho, Luiz Sergio</au><au>Modolo, Rodrigo</au><au>Santos, Simone</au><au>Silva, José Carlos Quinaglia E</au><au>Almeida, Osório Luis Rangel de</au><au>Sposito, Andrei C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction</atitle><jtitle>Arquivos brasileiros de cardiologia</jtitle><addtitle>Arq Bras Cardiol</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>116</volume><issue>3</issue><spage>466</spage><epage>472</epage><pages>466-472</pages><eissn>1678-4170</eissn><abstract><![CDATA[No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow.
We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow.
In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5).
A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001).
Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).]]></abstract><cop>Brazil</cop><pmid>33656051</pmid><doi>10.36660/abc.20200045</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9835-1906</orcidid><orcidid>https://orcid.org/0000-0001-8488-7662</orcidid><orcidid>https://orcid.org/0000-0001-7127-2052</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection; PubMed Central Open Access |
| subjects | Aged Coronary Angiography Humans Middle Aged Myocardial Infarction - diagnostic imaging No-Reflow Phenomenon - diagnostic imaging Percutaneous Coronary Intervention Prospective Studies ST Elevation Myocardial Infarction - diagnostic imaging ST Elevation Myocardial Infarction - surgery Thrombosis Treatment Outcome |
| title | Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction |
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