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Evaluación del puntaje SYNTAX por residentes de cardiología clínica;
Evaluation of the SYNTAX score by residents in clinical cardiology

Creators:Lamelas, Pablo M., Nau, Gerardo, Costabel, Juan P., Thierer, Jorge, Belardi, Jorge, Alves de Lima, Alberto
2012-07-26

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Descripción

Introducción El puntaje SYNTAX (PS) se presenta como una herramienta útil para la selección de pacientes con enfermedad del tronco y/o de tres vasos pasibles de revascularización mediante angioplastia. Existe una moderada reproducibilidad interobservador entre miembros del estudio original. No se dispone de evidencia suficiente sobre la evaluación del PS por miembros ajenos a un laboratorio de cardiología intervencionista. Objetivos Evaluar si residentes de cardiología pueden realizar una evaluación adecuada del PS y detectar posibles sesgos en ella. Material y métodos Se seleccionaron en forma retrospectiva cinecoronariografías que evidenciaban enfermedad del tronco y/o de tres vasos. Un residente de cardiología (RC) calculó el PS total para compararlo con lo calculado por un cardiólogo intervencionista (CI). Se analizaron los datos mediante el coeficiente kappa (deciles y terciles), el coeficiente de concordancia de Lin y gráficamente a través del método de Bland-Altman.   Resultados Se analizaron 93 cinecoronariografías. Las medias del PS del CI y del RC resultaron de 28,58 (DE 10,0) y de 30,44 (DE 10,7), respectivamente. La diferencia de las medias fue de 1,85 (DE 7,01). El coeficiente kappa resultó de 0,57 (0,464-0,678) para deciles y de 0,60 para terciles (0,48-0,72). El coeficiente de Lin fue de 0,75 (0,65 a 0,83). El análisis de Bland-Altman detectó una tendencia del RC a infraestimar puntajes altos del CI. Conclusiones El presente trabajo demuestra una moderada a buena reproducibilidad interobservador entre un RC y un CI. Este nivel de acuerdo es tolerable para su cálculo según lo publicado. Se detectó una tendencia del RC a infraestimar PS altos.Rev Argent Cardiol 2012;80 doi:10.7775/rac.v80.i4.1327

Background The SYNTAX score (SS) is a useful tool for selecting patients with left main or three-vessel coronary artery disease eligible for percutaneous coronary interventions. The score has moderate inter-observer reproducibility among members of the original study. There is not sufficient evidence about the evaluation of the SS by non-interventional cardiologists. Objectives The aim of the study was to evaluate whether residents in cardiology can perform an adequate evaluation of the SS and to detect possible biases in its evaluation. Methods Coronary angiographies with evidence of main left coronary artery disease and/or three-vessel disease were retrospectively selected. A resident in cardiology (RC) calculated the total SS in order to compare it with the score calculated by an interventional cardiologist (IC). Data were analyzed using the kappa coefficient (deciles and tertiles), Lin’s concordance correlation coefficient and the Bland-Altman plot method. Results Ninety three coronary angiographies were analyzed. Mean SS calculated by the IC and the RC were 28.58 (SD 10.0) and 30.44 (SD 10.7), respectively. Mean difference was 1.85 (SD 7.01). The kappa coefficient was 0.57 (0.464-0.678) for deciles and 0.60 for tertiles (0.48-0.72). Lin’s coefficient was 0.75 (0.65 to 0.83). The Bland-Altman analysis detected that the RC had a trend towards underestimating high scores calculated by the IC. Conclusions This study demonstrates a moderate to good inter-observer reproducibility between a RC and an IC. This level of agreement is acceptable to calculate the score, as previously published. A trend to underestimate high SS was detected in the RC.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 80, No 4 (2012), Argentine Journal of Cardiology; Vol 80, No 4 (2012)

Citación

Lamelas, Pablo M. et al., “Evaluación del puntaje SYNTAX por residentes de cardiología clínica,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8113.

Dublin Core

Materia

Autor

Lamelas, Pablo M.
Nau, Gerardo
Costabel, Juan P.
Thierer, Jorge
Belardi, Jorge
Alves de Lima, Alberto

Fuente

Revista Argentina de Cardiología; Vol 80, No 4 (2012)
Argentine Journal of Cardiology; Vol 80, No 4 (2012)

Editor

Sociedad Argentina de Cardiología

Fecha

2012-07-26

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

Idioma

eng
spa

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion