Alfredo E Rodriguez
Centro de Estudios en Cardiolog�?a Intervencionista, Argentina
Scientific Tracks Abstracts: J Clin Exp Cardiolog
Recently, an angiographic score was introduced in clinical practice to stratified different levels of risk after PCI. The SYNTAX score (SS) classified patients in three different risk levels. Patients allocated with low SS could be equally treated with either PCI or CABG, whereas those with intermediate or high SS were better off with CABG. However, using original SS each coronary lesion with a diameter stenosis â�?¥50% in vessels â�?¥1.5 mm was scored. In contrast, in ERACI IV study, which included patients with multiple vessel disease and unprotected left main stenosis treated with 2nd generation DES, we used a revascularization strategy during PCI where operators were advised to only treat lesions â�?¥ than 70% in a â�?¥ 2.0mm reference vessel; therefore, no intermediate lesions should be treated and severe stenosis in vessels â�?¤ 2.0 mm was discouraged as well. If we recalculated SS using the above-mentioned operators' advices all intermediate lesions were not scored and severe stenosis in vessels < 2.0 mm were excluded for the analysis; after this new scoring, the original SS dropped from 27.7 to 22. More over after this new scoring in ERACI IV, low SS rose to 54.8%, intermediate dropped to 27.9% and only 17.2% of ERACIâ�?�?s patients scored a high SS. At 24.5 months of follow up, MACCE rate was only 6.7%, composite of death/MI and stroke was 3.6% and unplanned new revascularization 4%. In conclusion, if we performed a SS scoring only severe stenosis in vessels with a reference diameter â�?¥ 2.0 mm would allow a more rational assessment of coronary anatomy which was associated with low events rate at 2 years of follow up.
Alfredo E Rodriguez graduated from Córdoba National Medical University, Argentina and completed his PhD from the Cordoba Catholic School of Medicine. He is Director of Centro de Estudios en Cardiología Intervencionista, a premier Research Organization and Head of the Cardiology Department of Sanatorio Otamendi, Buenos Aires, Argentina. He has published more than 250 papers in major peer review journals and also was Editor of four cardiology books the last one published in September 2015 by Springer. He is Editor-In-Chief of the Journal “Revista Argentina de Cardioangiología Intervencionista” and has been serving as an Editorial Board Member of worldwide repute Journals such as Euro-Intervention, JACC Cardiovascular Interventions, World Journal of Cardiology, Drug Designing Journal (2014), Journal of Developing Drugs (2014). He is also frequent reviewer from major cardiology and interventional cardiology Journals.