The SYNTAX score question in multivessel STEMI isn't settled. Complete revascularization versus culprit-only PCI in haemodynamically stable patients with 2VD or 3VD — the outcomes data is split enough that your choice of management strategy should be informed by institutional outcomes data, not just by the trial literature published from centres with patient populations that may not match yours. This template is the instrument for building that institutional data from retrospective case review.
The Lesion and Intervention Record
Culprit Vessel IRA with Intervention 1, Non Culprit N-IRA 1 through Non Culprit N-IRA 2 and their respective interventions document the revascularization strategy per case. A three-vessel STEMI with culprit LAD addressed at the index procedure and staged non-culprit RCA and LCx interventions is captured differently from a case where all three vessels were treated in the same session. The strategy classification — 2VD, 3VD, Culprit Category — combined with the intervention fields creates the dataset that allows you to compare outcomes by revascularization strategy within your institution.
SYNTAX 1 and SYNTAX 2 are the baseline and post-revascularization SYNTAX scores. The residual SYNTAX score — SYNTAX 2 — is increasingly recognized as a predictor of MACE at follow-up independent of the initial lesion complexity. Capturing both allows your analysis to examine whether residual SYNTAX, not just initial presentation severity, is the outcome driver in your population.
EF (by TTE) is the left ventricular function at the index presentation — the single most important predictor of all-cause mortality at 12 months in STEMI, and the field that provides the haemodynamic context for the revascularization strategy decisions logged elsewhere in the record. Kilip >=II on Admission and IABP are the haemodynamic instability indicators that further stratify the risk context.
Comorbidity and Risk Factor Profiling
Treated DM, Treated HTN, Treated HChol, COPD, PVD, Previous MI, Previous PCI, and Creatine Clearance constitute the comorbidity registry for each case. For a multicenter analysis, this cluster of fields is what controls for baseline risk differences between groups when comparing revascularization strategies. A complete revascularization cohort with significantly higher rates of treated DM and reduced EF is not a fair comparison to a culprit-only cohort with lower comorbidity burden without statistical adjustment using these variables.
Smoker, Sex, Age, and A&E Diagnosis complete the demographic and presentation profile. ECG Myocardial Wall Involvement — anterior, inferior, lateral, posterior — captures the index infarct territory. Anterior STEMI with anterior wall involvement carries different mortality and HF risk than inferior STEMI in a population with equivalent comorbidity burden.
MACE and Secondary Outcomes
All Cause Mortality, Recurrent MI, Repeat Revascularization, Heart Failure, and MACE Total are the outcome fields. The composite MACE Total is the primary endpoint; the disaggregated components identify which outcomes are driving the composite in your population. If your complete revascularization group has equivalent mortality but significantly lower repeat revascularization, that's a different clinical message than equivalent mortality and equivalent revascularization but lower HF rates.
Aspirin, Clopidogrel, Beta Blocker, ACE/ARB, and Statin are the secondary prevention pharmacotherapy fields at discharge. Guideline-directed medical therapy adherence at discharge is independently associated with 12-month outcomes, and including these fields allows your outcome analysis to account for whether MACE differences between groups are driven by revascularization strategy or by pharmacotherapy differences at discharge.
Approach Radial/Femoral/Both and Total Number of Stents close the procedural detail record. Radial access versus femoral access is a confounding variable in bleeding outcome analysis. Stent count is a proxy for total lesion length treated, which affects restenosis and stent thrombosis risk at follow-up.