Validation of the long-term prognostic capability of the SYNTAX score II in patients undergoing biodegradable polymer-based Sirolimus-eluting stents: 2-years outcomes from the PANDA III trial

Abstract Background This study aimed to assess the prognostic ability of SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Score II (SS-II) in LM and/or 3VD patients undergoing biodegradable polymer-based drug-eluting stents (BP-DES) in the multi-central randomized PANDA III trial. Methods A total of 723 patients in PANDA III population were enrolled in this study. According to SS-II tertiles, patients were stratified as follow: SS-II ≤ 23 (n = 224), 23   31 (n = 244). The predictive ability for 2-year cardiac death were compared between angiographic scores and scores combining both angiographic and clinical variables. Results Mean anatomic SS was 20.6 ± 9.4, SS-II was 28.7 ± 8.6. During 2-year follow up, cardiac death (0.00% vs. 1.7% vs. 4.3%, p = 0.003) and target lesion failure (5.9% vs. 9.1% vs. 13.6%, p = 0.020) was significantly higher in the upper tertile group than in intermedian and low tertile. At multivariate analysis, SS-II for PCI was an independent risk factor of cardiac death (Hazard ratio: 2.41, 95%CI: 1.47–3.97, p  Conclusions The SS-II had superiority than pure angiograph SYNTAX score in predicting 2-year cardiac death and TLF in patients with LM and/or 3VD undergoing PCI with biodegradable polymer drug-eluting stent.