Background Residual SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Score (RSS) is an objective measure for the assessment of degree and complexity of residual stenosis after the percutaneous coronary intervention (PCI). Aim The study aimed at evaluating the role of angiographic complete (CR) and incomplete (ICR) revascularization on clinical outcomes in patients undergoing PCI for multivessel coronary artery disease (MVCAD). The study sought to investigate the role of initial and residual severity of coronary atherosclerosis in prognostication of patients with MVCAD who underwent PCI. Material and Methods We retrospectively recruited 135 patients having MVCAD who underwent PCI. Coronary angiogram was used to assess the severity of coronary atherosclerosis. From the angiographic data baseline (BSS) and RSS were calculated. Subjects having a RSS of 0 were defined as having CR, and those having RSS > 0 are defined as ICR group. The study population was subgrouped into two groups as follows: CR, 0 (n = 17, 23%); ICR, >0 to 4 (n = 89, 47.2%). Clinical outcomes were measured, which included major adverse cardiac and cerebrovascular events (MACE) at 1 year. Results Among the study subjects mean age was 57.25 ± 17.55. About 76.3% were males, and 23.7% were females. About 89.4% had diabetes, 88.6% had hypertension as risk factors, and 95.8% were smokers. The mean values of BSS and RSS were 20.2 ± 9.2 and 4.1 ± 7.0, respectively. Based on RSS the individuals were divided into two groups as follows: CR, 0 (n = 17, 23%); ICR, > 0 to 4 (n = 89, 47.2%), > 4 to 8 (n = 16, 21.6%), > 8 (n = 13, 17.55%). After 1 year, three patients lost the follow-up. Among the remaining 132 patients, those with higher BSS had more mortality and morbidity, and the difference is statistically significant (MACE in ≥23 vs. <23, p = 0.000755); 10 patients in the ICR group had MACE compared with 1 patient in CR group(5.8% in CR group vs. 8.6% in ICR group, p-value of 0.38); however, the difference was not statistically significant. However, higher RSS acts as an indirect marker of increasing morbidity and mortality when compared within the tertiles, and the difference was statistically significant (RSS 1-4 group vs. > 4 MACE, p = 0.0009559, RSS < 8 vs. >8 MACE, p = 0.00000172). Conclusions This study proved that both BSS and higher RSS help to foretell the risk of adverse clinical outcomes in individuals with MVCAD who underwent PCI. RSS, which is an indirect marker of residual atherosclerosis, that is, ICR, had a positive correlation MACE after PCI. AbstractKeywords ► residual SYNTAX Score (RSS) ► multivessel coronary artery disease (MVCAD) ► complete revascularization (CR) ► incomplete revascularization (ICR)

Background Cardiovascular diseases, especially coronary artery disease (CAD), have assumed epidemic proportions worldwide. CAD is the leading cause of disability and death in women. In woman during postmenopausal years, traditional risk factors tend to become very present and increase the risk for CAD. Patterns in epidemiology of CAD are doubtlessly changing continually in many ways, only some of which are recognized at any given point of time. Aim To identify the changing trends of CAD in female patients who were admitted for coronary angiogram (CAG) over a period of 10 years. Materials and Methods We retrospectively collected the data of female patients from our unit CAG registry. We noted the demographic data (age, ethnicity, socioeconomic status), clinical data (diabetic status, hypertension status, symptoms and their duration, past history), laboratory data (complete blood picture, cardiac enzymes, renal function tests, liver function tests, serum electrolytes), and CAG findings (normal coronaries [NC]/single-vessel disease [SCD]/double-vessel disease [DVD]/triple-vessel disease [TVD]) of the female patients in 2007 and a decade later that was 2017. Results Data of 64 women in 2007 and of 184 in 2017 were analyzed. CAG women in 2017 were older than those in 2007 (53.1 ± 11.7 vs. 57.1 ± 12.3 years; p = 0.024). There was no significant difference found in the parameters such as hypertension (p = 0.797), diabetes mellitus (DM) (37.5% vs. 41.3%; p = 0.59), left ventricular (LV) dysfunction, type of presentation (acute coronary syndrome [ACS] or chronic stable angina [CSA]) and presence of CAD (53.9% vs. 51.1%; p = 0.69). In the 2017 female group, there was increase in detection of the electrographic (ECG) abnormalities (98.4% vs. 62.5%; p = 0.000). Radial route was used more frequently for CAG (98.4% vs. 40.6%; p = 0.000). Subgroup analysis of CAD (proven angiographically) showed a statistically significant difference of occurrence of SVD that was more frequent in 2007 female group (32.8% vs. 20.1%; p = 0.05), whereas TVD (was more frequent in 2017 female group (14.1% vs. 4.6%; p = 0.01). Conclusion This study shows that even though there was no change in the incidence of occurrence of normal coronaries on angiogram over time; however, there was a significant increase in severity of the CAD (TVD) in 2017 female group (p = 0.01).