Combining FAME and SYNTAX in a Functional Score Improves Risk Assessment

Using ischemia-producing lesions only in the SYNTAX score reduces the number of highest-risk patients and improves prediction of adverse events in patients with multivessel CAD.

In the FAME trial, functional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) was associated with a reduction in major adverse events compared with PCI guided by angiography alone in patients with multivessel coronary artery disease (JW Cardiol Jan 14 2009). In this analysis, investigators examined the accuracy of a “functional SYNTAX score” (FSS) derived by recalculating the SYNTAX risk score using ischemia-producing lesions only (FFR measurements ≤0.8) and not including lesions with FFR >0.8.

About one third of patients were reclassified from a higher-risk SYNTAX score tertile to a lower-risk FSS tertile. In patients with low, medium, and high FSS, rates of death or myocardial infarction (MI) at 1 year were 4.8%, 7.5%, a…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI