Age-Dependent Impact of the SYNTAX-score on Longer-Term Mortality after Percutaneous Coronary Intervention in an All-Comer Population

Background The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX)-score is a validated tool for risk stratification and revascularization strategy selection in patients with complex coronary artery disease. The aim of this study was to analyse its age-related prognostic value. Methods SYNTAX-score was calculated in 1331 all-comer patients undergoing percutaneous coronary intervention (PCI): 463 patients >= 75 years and 868 patients = 75 years, HR: 1.37, 95% CI: 1.01-1.85, P = 0.042), but only two-year mortality among younger patients ( = 75 years, HR: 1.11, 95% CI: 0.87-1.41, P = 0.394). SYNTAX-score tertiles were useful to stratify 1-year mortality in both, patients = 20, 10.3%;P = 0.004) and >= 75 years (SYNTAX-score = 22.5, 18.7%;P = 0.003), but two-year mortality only among patients = 20, 15%;P = 75 years old patients (SYNTAX-score = 22.5, 27.9%;P = 0.138). Conclusions Age modifies the impact of the SYNTAX-score on longer-term mortality after PCI. Among patients = 75 years its predictive role is limited to the first year after PCI. Further studies are needed to evaluate the value of SYNTAX-score for selecting the most appropriate revascularization strategy among elderly patients.