Prognostic value of SYNTAX score based on coronary computed tomography angiography

Suh, Young Joo; Hong, Yoo Jin; Lee, Hye Jeong; Hur, Jin; Kim, Young Jin; Lee, Hye Sun; Hong, Sae Rom; Im, Dong Jin; Kim, Yun Jung; Park, Chul Hwan; Kim, Tae Hoon; Yoo, Koo Han; Choi, Byoung Wook

doi:10.1016/j.ijcard.2015.07.067

Cited by 17 publications

(14 citation statements)

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“…Of these patients, 92 and 54 were included in previous studies by Suh et al [ 8 , 9 ] One study evaluated the long-term prognostic value of the CT-SYNTAX score in a population who underwent both CCTA and ICA, and compared the prognostic value of the CT-SYNTAX score and ICA-SYNTAX score. [ 8 ] Another study investigated the diagnostic accuracy of CCTA and the CT-SYNTAX score for selection of CABG candidates. [ 9 ] Our study focused on the prognostic value of the CT-SYNTAX score in patients with complex CAD as documented on CCTA.…”

Section: Methodsmentioning

confidence: 99%

“…Computed tomographic (CT) scans were performed using a dual-source CT scanner (SOMATOM Definition Flash; Siemens Health Care, Forchheim, Germany), as described in detail previously. [ 8 ] Image reconstructions were conducted as previously described, using filtered back projection with a medium kernel (b36f), and the slice thickness of 0.75 mm with 0.5 mm increments. [ 8 ]…”

Section: Methodsmentioning

confidence: 99%

“…[ 5 – 9 ] A previous study demonstrated that the CT-SYNTAX score may have prognostic value for predicting major adverse cardiac events in patients with varying severities of CAD. [ 8 ] Nevertheless, the use of the CT-SYNTAX score in patients with complex CAD has not yet been well-established. Considering the high diagnostic accuracy of CT for CAD and the excellent correlation between the CT-SYNTAX score and ICA-SYNTAX score, we hypothesized that the CT-SYNTAX score may have prognostic value in patients with complex CAD.…”

Section: Introductionmentioning

confidence: 99%

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SYNTAX score based on coronary computed tomography angiography may have a prognostic value in patients with complex coronary artery disease

et al. 2017

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The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score is an invasive coronary angiography (ICA)-based score for quantifying the complexity of coronary artery disease (CAD). Although the SYNTAX score was originally developed based on ICA, recent publications have reported that coronary computed tomography angiography (CCTA) is a feasible modality for the estimation of the SYNTAX score.The aim of our study was to investigate the prognostic value of the SYNTAX score, based on CCTA for the prediction of major adverse cardiac and cerebrovascular events (MACCEs) in patients with complex CAD.The current study was approved by the institutional review board of our institution, and informed consent was waived for this retrospective cohort study. We included 251 patients (173 men, mean age 66.0 ± 9.29 years) who had complex CAD [3-vessel disease or left main (LM) disease] on CCTA. SYNTAX score was obtained on the basis of CCTA. Follow-up clinical outcome data regarding composite MACCEs were also obtained. Cox proportional hazards models were developed to predict the risk of MACCEs based on clinical variables, treatment, and computed tomography (CT)-SYNTAX scores.During the median follow-up period of 1517 days, there were 48 MACCEs. Univariate Cox hazards models demonstrated that MACCEs were associated with advanced age, low body mass index (BMI), and dyslipidemia (P < .2). In patients with LM disease, MACCEs were associated with a higher SYNTAX score. In patients with CT-SYNTAX score ≥23, patients who underwent coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention had significantly lower hazard ratios than patients who were treated with medication alone. In multivariate Cox hazards model, advanced age, low BMI, and higher SYNTAX score showed an increased hazard ratio for MACCE, while treatment with CABG showed a lower hazard ratio (P < .2).On the basis of our results, CT-SYNTAX score can be a useful method for noninvasively predicting MACCEs in patients with complex CAD, especially in patients with LM disease.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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SYNTAX score based on coronary computed tomography angiography may have a prognostic value in patients with complex coronary artery disease

et al. 2017

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“…The SYNTAX score includes many vulnerability parameters, thus utilization of the scoring system for long-term prognosis seems rational. Suh et al evaluated the performance of the SYNTAX score based on 339 patients who underwent both CTA and ICA (120). Only characteristics assessable by both CTA and ICA were included in the SYNTAX score.…”

Section: Syntax Scorementioning

confidence: 99%

Plaque imaging with CT—a comprehensive review on coronary CT angiography based risk assessment

Kolossváry¹,

Szilveszter²,

Merkely³

et al. 2017

Cardiovasc. Diagn. Ther.

110

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CT based technologies have evolved considerably in recent years. Coronary CT angiography (CTA) provides robust assessment of coronary artery disease (CAD). Early coronary CTA imaging-as a gate-keeper of invasive angiography-has focused on the presence of obstructive stenosis. Coronary CTA is currently the only non-invasive imaging modality for the evaluation of non-obstructive CAD, which has been shown to contribute to adverse cardiac events. Importantly, improved spatial resolution of CT scanners and novel image reconstruction algorithms enable the quantification and characterization of atherosclerotic plaques. State-of-the-art CT imaging can therefore reliably assess the extent of CAD and differentiate between various plaque features. Recent studies have demonstrated the incremental prognostic value of adverse plaque features over luminal stenosis. Comprehensive coronary plaque assessment holds potential to significantly improve individual risk assessment incorporating adverse plaque characteristics, the extent and severity of atherosclerotic plaque burden. As a result, several coronary CTA based composite risk scores have been proposed recently to determine patients at high risk for adverse events. Coronary CTA became a promising modality for the evaluation of functional significance of coronary lesions using CT derived fractional flow reserve (FFR-CT) and/or rest/dynamic myocardial CT perfusion. This could lead to substantial reduction in unnecessary invasive catheterization procedures and provide information on ischemic burden of CAD. Discordance between the degree of stenosis and ischemia has been recognized in clinical landmark trials using invasive FFR. Both lesion stenosis and composition are possibly related to myocardial ischemia. The evaluation of lesion-specific ischemia using combined functional and morphological plaque information could ultimately improve the diagnostic performance of CTA and thus patient care. In this review we aimed to summarize current evidence on comprehensive coronary artery plaque assessment using coronary CTA.

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“…Наши результаты подтверждают данные исследования [9], где 339 пациентам выполнили МСКТ-коронарографию и стандартную КАГ с оценкой эффективности шкалы SYNTAX при этих методах. При расчете SYNTAX использовались данные, доступные для оценки двумя ме-Рис.…”

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Best Strategy of Coronary Arteries Revascularization With the Syntax Scale and Cad-Rads on the Data of 640-Slice Ct-Coronarography

Серова¹,

Kondrashina²,

Kondrashin³

et al. 2019

Rejr

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ель. Определить возможности применения шкалы SYNTAX по данным 640срезовой КТ-коронарографии и системы оценки для реваскуляризации коронарных артерий. Материалы и методы. В исследование включено 14 человек (12 мужчин, 2 женщины) в возрасте от 44 до 79 лет (Мср=60,5±8,7 лет), которым провели плановое стентирование коронарных артерий только на основании данных МСКТкоронарографии и положительных тестов с нагрузкой. Всем пациентам выполнена МСКТ-коронарография на компьютерном томографе Aquilion ONE-640 с внутривенным контрастированием (контрастный препарат Йопромид 370 мг/мл или Йогексол 350 мг/мл) по стандартному протоколу. Дополнительно были изучены результаты определения метода выбора реваскуляризации миокарда на основании шкалы Syntax по данным 640-срезовой КТ-коронарографии и инвазивной коронарографии (проводилась во время стентирования). Результаты. В 14 случаях изменения коронарных артерий по результатам МСКТ-коронарографии соответствовали категориям CAD-RADS 4А, Б и CAD-RADS 5. По данным МСКТ-коронарографии у 14 пациентов имелось стенотическое поражение 18 артерий, по данным коронарографии в одном наблюдении стеноз был 50%. Всего 13 пациентам было имплантирован 21 стент. В правую коронарную артерию установлено 9 стентов (42,9%), в переднюю межжелудочковую и огибающую артерии-12 (57,1%). По шкале Syntax проведена оценка тяжести поражения коронарного русла на основании данных МСКТ-коронарографии и инвазивной коронарографии для выбора тактики лечения. По данным томографии балл поражения колебался от 2,0 до 14,5 (Мср=5,7±3,3), на основании традиционной коронарографии он составил от 0 до 16,5 (Мср=5,2±3,1). Разница статистически недостоверна (Р>0,05). Заключение. 640-срезовая КТ-коронарография является надежной альтернативой инвазивной коронарографии и может стать методом выбора тактики лечения на основе оценки шкалы Syntax и системы CAD-RADS. Ключевые слова: 640-срезовая КТ-коронарография, ишемическая болезнь сердца, шкала Syntax, CAD-RADS, инвазивная коронарография, стентирование.

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Prognostic value of SYNTAX score based on coronary computed tomography angiography

Cited by 17 publications

References 29 publications

SYNTAX score based on coronary computed tomography angiography may have a prognostic value in patients with complex coronary artery disease

SYNTAX score based on coronary computed tomography angiography may have a prognostic value in patients with complex coronary artery disease

Plaque imaging with CT—a comprehensive review on coronary CT angiography based risk assessment

Best Strategy of Coronary Arteries Revascularization With the Syntax Scale and Cad-Rads on the Data of 640-Slice Ct-Coronarography

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