SYNTAX scoring in patients with coronary artery disease and its effect on mode of revascularization, single center experience

Abstract EN

Background: Revascularization therapy for patients with left main (LM) and/or three vessels coronary disease is a matter of argument for long a time whether bypercutaneous coronary angioplasty or coronary artery bypass grafting.

SYNTAX trial was designed to assess the optimal revascularization strategy between percutaneous coronary intervention and coronary artery bypass grafting, for patients with left main stem coronary artery disease and/or 3-vessel coronary disease.

Objectives: To estimate the complexity of coronary artery disease in patients referred to a tertiary cardiac center and its effect on mode of revascularization.

Method: Ninety nine patients who were referred to Iraqi center for heart disease from July to December 2010 with the diagnosis of coronary artery disease were included.

Full history, clinical examination, biochemical tests ( blood sugar,total cholesterol, blood urea and serum creatinine) were checked, electrocardiographic and echocardiographic characteristics were analyzed ,All patients underwent diagnostic angiography and SYNTAX score calculator was applied and the SYNTAX score was recorded.

Patients were divided into two groups: group A , those who were planned for PCI and group B who were planned for CABG .

Results: Mean age of the patients was 57.6±10.6, ranging 19-80 year, male were more than female (75.8% vs.

24.6%).

Risk factors diabetes mellitus (42.6%), high blood pressure (52.8 %), smoking (42.4%), hypercholesterolemia (43.4%) and prior Ml (32.3%).Mean age of group A was 54.22±11.27 while group B was 62.37±7.47 (P value 0.0001).

There was no significant difference in risk factors prevalence between group A and B ( DM 36.2% vs.51.2% p=0.31), hypertension(53.4% vs.53.3% p=0.98), smoking (41.3% vs.43.9% p=0.8), hypercholestoemia (31% vs.

60.9%),ejection fraction<50% ( 20.6% vs.

24.3% ) (p=0.66).

All patient with left main steam disease 13 (31.7%) passed to CABG group.

Mean total SYNTAX score for all patients was 16.7±6.5.

Mean SYNTAX score were (10.24±6, 26.01±7.7) for group A and B respectively (P value 0.00001).

Conclusion: Patients with lower SYNTAX score were managed by PCI.

Patients treated with PCI have lower syntax score than that in SYNTAX study, while those who were treated by CABG, were comparable to that in SYNTAX study.