Prognostic value of Delta SYNTAX% score in octogenarians undergoing percutaneous coronary intervention

OBJECTIVES To verify whether incomplete revascularisation (IR), quantified using the rSYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score and Delta SYNTAX% score, could predict short- (in-hospital mortality) and long-term outcomes (12-month mortality) in octogenarians undergoing percutaneous coronary intervention (PCI). METHODS & RESULTS A retrospective analysis of 665 consecutive octogenarian patients presenting for PCI to a UK centre was performed. The baseline SYNTAX and rSYNTAX scores were assessed from angiographic images. Delta SYNTAX% score was calculated (Delta SYNTAX% = ((SYNTAX - rSYNTAX)/SYNTAX) x 100%)) to measure the relative completeness of revascularisation. Kaplan-Meier analysis assessed survival at 12 months by tertiles of rSYNTAX and.SYNTAX% scores. Increasing.SYNTAX% score was associated with reduced in-hospital mortality ( P = 0.017), and improved survival benefit (log rank 14.8, P = 0.001) at 12 months. CONCLUSIONS Enhancing the completeness of revascularisation in octogenarians selected to undergo PCI is associated with a lower in-hospital mortality and a survival benefit at 12 months.