DataVXAdvanced SciencePaper
journal article·2025-04Open access

Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial

Rui Zhang, Shaoyu Wu, Qianqian Liu, Changdong Guan, Hao‐Yu Wang, Sheng Yuan, Lihua Xie, Yunfei Huang, Zheng Qiao, Weida Liu, Rui Fu, Lei Feng, Chenggang Zhu, Lei Song, Dong Yin, Kefei Dou

Advanced Science· Volume 12· Issue 14
Publisher pageOpen full text
Source abstract

Abstract

Abstract Functional complete revascularization (CR) after percutaneous coronary intervention (PCI) as determined by classic residual functional SYNTAX score (c‐rFSS) has been associated with improved prognosis. In this study, the c‐rFSS algorithm is optimized for a novel modified rFSS (m‐rFSS) and prognostic implications of this novel scoring is determined. The m‐rFSS algorithm is updated for 2 clinical scenarios, i.e., 1) lesions with suboptimal functional results, and 2) angiographic diameter stenosis <50% but functionally significant stenoses, which are not scored by c‐rFSS. The major outcome is a 2‐year major adverse cardiac event (MACE). A total of 1,555 patients analyzable for both c‐rFSS and m‐rFSS are included. After calculating m‐rFSS, 12.0% (187/1,555) of patients with c‐rFSS‐based functional CR (c‐rFSS = 0) are reclassified as having m‐rFSS‐based incomplete revascularization (IR, m‐rFSS>0); thus, 377 (21.7%) patients have c‐rFSS‐based functional IR whereas 524 (33.7%) has m‐rFSS‐based IR. Patients with m‐rFSS‐based functional IR (m‐rFSS>0) show a significantly higher risk for major MACE outcome (20.8% vs 5.9%; adjusted hazard ratio 3.32, 95% confidence interval: 2.34–4.71) than patients with functional CR (m‐rFSS = 0). The m‐rFSS is more predictive of 2‐year MACE than c‐rFSS (difference in C‐index 0.07, p < 0.001). In this study, we optimized the classic scoring algorithm to develop a novel scoring system (m‐rFSS), and revascularization completeness determined by m‐rFSS is markedly associated with a 2‐year prognosis.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Coronary Interventions and Diagnostics · Cardiac Imaging and Diagnostics · Cardiac, Anesthesia and Surgical Outcomes

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Cardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Department of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

State Key Laboratory of Cardiovascular Disease Beijing 102300 China

Department of Cardiology Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou 510080 China

Catheterization Laboratories National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

State Key Laboratory for Complex Severe, and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China

National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen 518038 China

Funding

Fundamental Research Funds for the Central Universities

References (38)

Show source-provided references
1. 10.1093/eurheartj/ehy81210.1093/eurheartj/ehy812 ↗
2. 10.1056/NEJMoa120536110.1056/NEJMoa1205361 ↗
3. 10.1056/NEJMoa080761110.1056/NEJMoa0807611 ↗
4. 10.1056/NEJMoa170044510.1056/NEJMoa1700445 ↗
5. 10.1056/NEJMoa161654010.1056/NEJMoa1616540 ↗
6. 10.1016/S0140-6736(21)02248-010.1016/S0140-6736(21)02248-0 ↗
7. 10.1161/CIRCULATIONAHA.121.05851910.1161/CIRCULATIONAHA.121.058519 ↗
8. 10.1093/eurheartj/ehy39410.1093/eurheartj/ehy394 ↗
9. 10.4244/EIJ-D-23-0019410.4244/EIJ-D-23-00194 ↗
10. 10.1038/s41569-020-00457-510.1038/s41569-020-00457-5 ↗
11. 10.1161/CIRCULATIONAHA.113.00180310.1161/CIRCULATIONAHA.113.001803 ↗
12. 10.1016/j.jcin.2017.09.00910.1016/j.jcin.2017.09.009 ↗
13. 10.1016/j.jcin.2022.10.01410.1016/j.jcin.2022.10.014 ↗
14. 10.1161/CIRCULATIONAHA.117.02878210.1161/CIRCULATIONAHA.117.028782 ↗
15. 10.1016/j.jcin.2012.07.00710.1016/j.jcin.2012.07.007 ↗
16. 10.1093/eurheartj/ehu09410.1093/eurheartj/ehu094 ↗
17. 10.1093/eurheartj/ehad31810.1093/eurheartj/ehad318 ↗
18. 10.1161/CIRCINTERVENTIONS.118.00696110.1161/CIRCINTERVENTIONS.118.006961 ↗
19. 10.1093/eurheartj/ehab18610.1093/eurheartj/ehab186 ↗
20. 10.1016/j.jcin.2019.06.00310.1016/j.jcin.2019.06.003 ↗
21. 10.1016/j.jcin.2019.08.00910.1016/j.jcin.2019.08.009 ↗
22. 10.1016/j.jacc.2016.03.47510.1016/j.jacc.2016.03.475 ↗
23. 10.4244/EIJ-D-17-0094610.4244/EIJ-D-17-00946 ↗
24. 10.1016/j.jacc.2017.10.03510.1016/j.jacc.2017.10.035 ↗
25. 10.1016/j.jacc.2022.09.00710.1016/j.jacc.2022.09.007 ↗
26. Sianos G. · EuroIntervention · 2005 · 1 · 219
27. 10.1016/S0140-6736(15)00057-410.1016/S0140-6736(15)00057-4 ↗
28. 10.1056/NEJMoa180353810.1056/NEJMoa1803538 ↗
29. 10.1016/j.jacc.2016.01.05610.1016/j.jacc.2016.01.056 ↗
30. 10.1016/j.diabres.2022.10983910.1016/j.diabres.2022.109839 ↗
31. 10.1016/j.jacasi.2023.03.01410.1016/j.jacasi.2023.03.014 ↗
32. 10.1016/S0140-6736(13)60108-710.1016/S0140-6736(13)60108-7 ↗
33. 10.1016/S0140-6736(20)32114-010.1016/S0140-6736(20)32114-0 ↗
34. 10.1093/ehjdh/ztad01410.1093/ehjdh/ztad014 ↗
35. 10.1161/CIRCULATIONAHA.123.06399610.1161/CIRCULATIONAHA.123.063996 ↗
36. Collet C. · Eur. Heart J. · 2018 · 39 · 3689
37. 10.1002/ccd.2959210.1002/ccd.29592 ↗
38. 10.1016/j.jcin.2023.04.02610.1016/j.jcin.2023.04.026 ↗