Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil

Abstract

Background:The importance of coronary anatomy in predicting cardiovascular events is well known. The use of traditional anatomical scores in routine angiography, however, has not been incorporated to clinical practice. SYNTAX score (SXscore) is a scoring system that estimates the anatomical extent of coronary artery disease (CAD). Its ability to predict outcomes based on a baseline diagnostic angiography has not been tested to date.Objective:To evaluate the performance of the SXscore in predicting major adverse cardiac events (MACE) in patients referred for diagnostic angiography.Methods:Prospective cohort of 895 patients with suspected CAD referred for elective diagnostic coronary angiography from 2008 to 2011, at a university-affiliated hospital in Brazil. They had their SXscores calculated and were stratified in three categories: no significant CAD (n = 495), SXscoreLOW-INTERMEDIATE: < 23 (n = 346), and SXscoreHIGH: ≥ 23 (n = 54). Primary outcome was a composite of cardiac death, myocardial infarction, and late revascularization. Secondary endpoints were the components of MACE and death from any cause.Results:On average, patients were followed up for 1.8 ± 1.4 years. The primary outcome occurred in 2.2%, 15.3%, and 20.4% in groups with no significant CAD, SXscoreLOW-INTERMEDIATE, and SXscoreHIGH, respectively (p < 0.001). All-cause death was significantly higher in the SXscoreHIGH compared with the 'no significant CAD' group, 16.7% and 3.8% (p < 0.001), respectively. After adjustment for confounding factors, all outcomes remained associated with the SXscore.Conclusions:SXscore independently predicts MACE in patients submitted to diagnostic coronary angiography. Its routine use in this setting could identify patients with worse prognosis.

Correlation of Glycosylated Hemoglobin and Complexity of Coronary Artery Disease among Aged ≥45 Years Population with Diabetes Mellitus

“…SYNTAX score is widely used by interventional cardiologists and cardiothoracic surgeons to predict the severity/complexity of coronary artery disease and to determine the post-operative outcome of patients undergoing CABG or PCI. Literature from international centers shows favorable outcome of CABG if the Syntax score comes more than ≥34 [18][19][20]. In our study only 7.2% (n = 11) patients had Syntax score more than 34 and fall into high-risk Syntax score group while the majority had low (75.2%, n 115) and intermediate (17.6%, n = 27) risk Syntax score, respectively and when high-risk Syntax score patients were separately evaluated for correlation with HbA1c levels, we have observed an insignificant association.…”

The Association Between SYNTAX Score and Long-term Outcomes in Patients With Unstable Angina Pectoris: a Single-center Retrospective Study

“…Previous reports demonstrated that patients with high SYNTAX score had worse prognosis, moreover, studies using SYNTAX scores reported its capacity to predict adverse events for patients undergiong PCI and the prognostic value of the SYNTAX score in all cause mortality was also shown at different points in time up to ve years after PCI [17][18][19][20] . This study reached the same conclusion that MACE was higher in patients with high SYNTAX sore in both medical therapy group and PCI group.…”

The Association between Serum Heme Oxygenase-1 Levels and Coronary SYNTAX Score

“…The score includes the extent of the CAD as well as the complexity of coronary anatomy as score variables. The prognostic impact of the SYNTAX score on patients with CAD, including acute coronary syndromes, was shown in subsequent studies [10,11]. In this study, we have aimed to show the association between serum HO-1 levels and the extent of significant CAD determined by the SYN-TAX score.…”