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 Results A significant interaction of age and SYNTAX-score for mortality was observed at two-year (Pinteraction = 0.019) but not at one-year follow-up (Pinteraction = 0.594). In multivariable analysis, SYNTAX-score independently predicted 1-year mortality in both age groups (P = 0.034; and ≥ 75 years, HR: 1.37, 95% CI: 1.01–1.85, P = 0.042), but only 2-year mortality among younger patients (P = 0.041; and ≥ 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 P = 0.004) and ≥ 75 years (SYNTAX-score P = 0.003), but 2-year mortality only among patients P P = 0.138). Conclusions Age modifies the impact of the SYNTAX-score on longer-term mortality after PCI. Among patients < 75 years, the SYNTAX-score independently predicts the risk of death at one and two years after PCI, while 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.