The SYNTAX score is correlated with long-term outcomes of coronary artery bypass grafting for complex coronary artery lesions

Cho, Yasunori; Shimura, Shinichiro; Aki, Akira; Furuya, Hidekazu; Okada, Kazutaka; Ueda, Toshihiko

doi:10.1093/icvts/ivw057

Cited by 21 publications

(12 citation statements)

References 25 publications

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“…In line with the current work, Cho et al reported that patients with low SYNTAX score had a significantly greater EF compared to those with a higher score (60.4% ± 10.6% with low, 58.1% ± 11.3% with intermediate, and 56.6% ± 11.3% with a high score; p = 0.025) [ 30 ].…”

Section: Discussionsupporting

confidence: 87%

A Comparison Between Two-Dimensional and Three-Dimensional Regional and Global Longitudinal Strain Echocardiography to Evaluate Complex Coronary Lesions in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

Raslan¹,

Elkhashab²,

Mousa³

et al. 2022

Cureus

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Introduction A preliminary assessment of patients who suffer from severe and complex coronary artery lesions, such as three-vessel disease and/or a left main (LM) artery lesion, plays a critical contribution in determining prognosis and treatment plans for non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Therefore, a pre-angiography (i.e., before angiography) predictor was required to cost-effectively evaluate severe and complex coronary lesions to efficiently direct our subsequent dealing. Aim This study aimed to compare two-dimensional (2D) and three-dimensional (3D) global longitudinal strain (GLS) at the regional level to assess extremely complicated coronary lesions using the SYNTAX score as a standard of reference in 100 patients with NSTE-ACS. Materials and methods This research included 100 patients with non-ST-segment elevation acute coronary syndrome who presented at the Cardiology Department at Fayoum University from December 2019 to July 2020. All patients underwent a complete history and physical examination, hemoglobin A1c (HbA1c), lipid profile, creatinine assessment, 12-lead electrocardiogram (ECG), and transthoracic echocardiography (TTE) to detect global and regional longitudinal strain by 2D and 3D speckle-tracking echocardiography (STE). Coronary angiography was done on all patients within 24 hours of admission after acquiring echo images. Then, the results of 2D and 3D regional and global longitudinal strain (GLS) to predict the severity and coronary lesion complexity in terms of the SYNTAX score were compared. Results This study revealed that 2D GLS was −12.10 ± 3.51, which is significantly higher than 3D GLS of −11.64 ± 4.05 (p < 0. 001). The left anterior descending coronary artery (LAD) and left circumflex artery (LCX) territories revealed a significantly higher value using 2D regional longitudinal strain (−11.13 ± 4.47 and −12.54 ± 4.11, respectively) than using 3D regional longitudinal strain (−10.84 ± 5.18 and −12.05 ± 4.29, respectively) (p= 0.017 and p < 0.001, respectively). There were significantly lower 2D GLS, 3D GLS, global circumferential strain (GCS), area strain, and global radial strain (GRS) in the intermediate and high score group than in the low score group of patients (p < 0.001 for all). Conclusion 2D and 3D strain echocardiography including GLS, GCS, GRS, and area strain are a noninvasive and rapid tool with clinical utility for evaluating coronary lesions in patients with NSTE-ACS. They can be routinely used to diagnose and stratify high-risk patients with NSTE-ACS, thereby potentially resulting in improved patient assessment. GLS as measured by 2D and 3D STE at minimal effort is a significant risk factor for patients with complex NSTE-ACS. In NSTE-ACS cases, the GLS absolute value is significantly associated with the degree of complexity of coronary artery lesions.

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Section: Discussionsupporting

confidence: 87%

A Comparison Between Two-Dimensional and Three-Dimensional Regional and Global Longitudinal Strain Echocardiography to Evaluate Complex Coronary Lesions in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

Raslan¹,

Elkhashab²,

Mousa³

et al. 2022

Cureus

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“…In addition to our main questions to understand the effects (and potential barriers) of undergoing CAG on patients’clinical outcomes, we also investigated the SYNTAX score in patients who underwent a CAG. The SYNTAX score is valuable for decision making and estimating prognosis depending on the treatment instigated: PCI 6,14–17 , CABG 18 , or optimal medical therapy (OMT) 19 . In our study, we found that patients who showed a high SS had comparable outcomes with the not-adhere group.…”

Section: Discussionmentioning

confidence: 99%

Adherence to guideline recommendations for coronary angiography in a poor South-East Asian setting: Impact on short- and medium-term clinical outcomes

Qanitha

Uiterwaal

Henriques

et al. 2019

Sci Rep

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In South-East Asian populations and particularly in Indonesia, access to coronary angiography (CAG) is limited. We aimed to assess the adherence for undergoing CAG for indicated patients, according to the guideline recommendations. We then examined whether this adherence would have an impact on patients’ short- and medium-term mortality and morbidity. We consecutively enrolled 474 patients with acute and stable coronary artery disease who had indication for CAG at Makassar Cardiac Center, Indonesia from February 2013 to December 2014. We found that adherence to CAG recommendation in poor South-East Asian setting is low. Of 474 recommended patients, only 273 (57.6%) underwent the procedure. Factors for not undergoing CAG were: older age, female gender, low educational and socio-economic status, and insurance type. While reasons for patients refusing CAG and subsequent intervention included fear, symptoms reduction, and lack of trust concerning the procedure benefit. During follow-up (median 19 (IQR 6–39.3) months), 155 (32.7%) patients died, and 259 (54.6%) experienced at least one adverse event. Adherence to CAG recommendation was associated with a significantly lower short- and medium-term mortality, independent of revascularization and other potential confounders. In sub-group analysis, adhered patients “with revascularization” had significantly better outcomes compared to the “non-revascularization” and “not adhere” groups.

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“…The patients had a mean age which varied from 62.0 to 71.4 years (except study Wykrzykowska 11 which included younger patients). All of the studies contained more male patients than female patients: (study Garg 9 : 72.9% versus 76.6%, study Garg 10 : 78.8% versus 74.1%, study Wykrzykowska 11 : 73.8% versus 73.8%, study Yadav 12 : 70.4% versus 66.0%, study Kim 14 : 51.4% versus 66.2%, study Cho 15 : 79.1% versus 73.6%, study Gannot 17 : 80.0% versus 82.0%, study Miyagi 18 : 85.7% versus 81.6%, study Capodanno 13 : 79.4% versus 75.9%, and study Shiomi 19 : 77.0% versus 71.0% male patients in the experimental versus the control group respectively). The percentage of patients with co-morbidities and other cardiovascular risk factors (hypertension, dyslipidemia, smoking, diabetes mellitus) was also listed ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery and the SYNTAX score: A systematic review and meta-analysis

Bundhun

Yanamala

Huang

2017

Sci Rep

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The SYNTAX [Synergy Between percutaneous coronary intervention (PCI) With Taxus and coronary artery bypass surgery (CABG)] score is a decision-making tool in interventional cardiology. However, several facts still remain to be addressed: What about PCI or CABG with a low versus a high score respectively? And what about PCI with a low score versus CABG with a high score? Electronic databases were carefully searched for relevant publications. Odds ratios (OR) with 95% confidence intervals (CIs) were calculated and the analysis was carried out by RevMan 5.3. Eleven studies with a total number of 11,037 patients were included. In terms of clinical outcomes, this analysis showed PCI to have significantly favored patients with a low versus a high SYNTAX score. In patients who were re-vascularized by CABG, mortality and major adverse cardiac events were significantly lower with a low SYNTAX score. However, when PCI with a low SYNTAX score was compared with CABG with a high SYNTAX score, no significant difference in mortality and combined death/stroke/myocardial infarction were observed. In conclusion, the SYNTAX score might be considered useful in interventional cardiology. Nevertheless, the fact that it has limitations when compared to newer tools should also not be ignored.

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The SYNTAX score is correlated with long-term outcomes of coronary artery bypass grafting for complex coronary artery lesions

Abstract: The SYNTAX score is correlated with long-term outcomes, in terms of MACCEs, after conventional CABG for complex coronary lesions and is prognostic of long-term outcomes of CABG for patients with complex lesions.

Cited by 21 publications

References 25 publications

A Comparison Between Two-Dimensional and Three-Dimensional Regional and Global Longitudinal Strain Echocardiography to Evaluate Complex Coronary Lesions in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

A Comparison Between Two-Dimensional and Three-Dimensional Regional and Global Longitudinal Strain Echocardiography to Evaluate Complex Coronary Lesions in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

Adherence to guideline recommendations for coronary angiography in a poor South-East Asian setting: Impact on short- and medium-term clinical outcomes

Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery and the SYNTAX score: A systematic review and meta-analysis

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