{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:08:26Z","timestamp":1792098506206,"version":"4.4.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The long\u2010term prognostic effect of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (SS) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) for left main coronary artery disease is controversial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In the PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus\u2010Eluting Stent in Patients With Left Main Coronary Artery Disease) trial, 600 patients with left main coronary artery disease were randomized to undergo PCI with drug\u2010eluting stents (n=300) or CABG (n=300). We compared 10\u2010year outcomes after PCI and CABG according to SS categories and evaluated the predictive value of SS in each revascularization arm. The primary outcome was a major adverse cardiac or cerebrovascular event (composite of death, myocardial infarction, stroke, or ischemia\u2010driven target\u2010vessel revascularization) at 10\u00a0years. Among 566 patients with valid SS measurement at baseline, 240 (42.4%) had low SS, 200 (35.3%) had intermediate SS, and 126 (22.3%) had high SS. The 10\u2010year rates of major adverse cardiac or cerebrovascular events were not significantly different between PCI and CABG in low (21.6% versus 22.2%,\n              <jats:italic>P<\/jats:italic>\n              =0.97), intermediate (31.8% versus 22.2%;\n              <jats:italic>P<\/jats:italic>\n              =0.13), and high SS (46.2% versus 35.7%;\n              <jats:italic>P<\/jats:italic>\n              =0.31) (\n              <jats:italic>P<\/jats:italic>\n              \u2010for\u2010interaction=0.46). There were no significant interactions between SS categories and revascularization modalities for death (\n              <jats:italic>P<\/jats:italic>\n              =0.92); composite of death, myocardial infarction, or stroke (\n              <jats:italic>P<\/jats:italic>\n              =0.87); and target\u2010vessel revascularization (\n              <jats:italic>P<\/jats:italic>\n              =0.06). Higher SS categories were associated with higher risks for major adverse cardiac or cerebrovascular events in the PCI arm but not in the CABG arm.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Ten\u2010year clinical outcomes between PCI and CABG were not significantly different according to the SS. The SS was predictive of major adverse cardiac or cerebrovascular events after PCI but not after CABG.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03871127.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020359","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T10:27:30Z","timestamp":1625567250000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Prognostic Effect of the SYNTAX Score on 10\u2010Year Outcomes After Left Main Coronary Artery Revascularization in a Randomized Population: Insights From the Extended PRECOMBAT Trial"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0617-3116","authenticated-orcid":false,"given":"Junghoon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4031-391X","authenticated-orcid":false,"given":"Jung\u2010Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Hyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5599-758X","authenticated-orcid":false,"given":"Yeong Jin","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4211-3081","authenticated-orcid":false,"given":"Junho","family":"Hyun","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-3462","authenticated-orcid":false,"given":"Ji Sung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology and Biostatistics Center for Medical Research and Information Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbit","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do\u2010Yoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pil Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6643-0239","authenticated-orcid":false,"given":"Duk\u2010Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-5405","authenticated-orcid":false,"given":"Seung\u2010Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on the behalf of the PRECOMBAT 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