Usefulness of the SYNTAX Score for Predicting Clinical Outcome After Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Disease

Capodanno, Davide; Salvo, M.; Cincotta, Glauco; Miano, Marco; Tamburino, C; Tamburino, Corrado

doi:10.1161/circinterventions.108.847137

Cited by 205 publications

(180 citation statements)

References 12 publications

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“…Dyson et al found that the FMD of the conduit peripheral arteries is dependent on the cumula-between FMD and L-FMC, the results of both measurements demonstrated an association with traditional risk factors of atherosclerosis. Further, both L-FMC and FMD showed a dose-effect relationship with the severity of coronary artery disease 33) . These data demonstrate that assessment of different endothelial functions provide information that is additive and complementary to that of traditional risk factors 34) .…”

Section: Flow-mediated Dilation (Fmd)mentioning

confidence: 86%

Testing Endothelial Function and its Clinical Relevance

Poredoš¹,

Ježovnik²

2013

JAT

107

109

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Endothelial dysfunction as an integrating index of the risk factor burden and genetic susceptibility is an early marker of atherothrombotic disease. Therefore, tremendous interest exists in its measurement and determination of the clinical utility of the evaluation of endothelial function. Different invasive and non-invasive techniques exist for exploring various aspects of the pathobiology of the endothelium. As endothelial dysfunction is a diffuse-systemic disorder, the peripheral arteries, because of their accessibility, represent the basis for assessment of endothelial dysfunction.

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Section: Flow-mediated Dilation (Fmd)mentioning

confidence: 86%

Testing Endothelial Function and its Clinical Relevance

Poredoš¹,

Ježovnik²

2013

JAT

107

109

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“…Metzler et al (18) pointed that SYNTAX score reflects only the coronary anatomy not patient characteristics and treatment strategy. And also, this score has been shown to predict cardiac mortality and major adverse cardiovascular events in patients undergoing percutaneous revascularization (11,18,19). However, NLR and other inflammatory markers like hs-CRP are not yet included any clinical and angiographic scoring system including GRACE, SYNTAX, TIMI, STS, Euroscore (18,20,21).…”

Section: Discussionmentioning

confidence: 99%

Relation of neutrophil -to- lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study

Sönmez

Ertaş²,

Bacaksız³

et al. 2013

Anadolu Kardiyol Derg

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Objective: The neutrophil -to-lymphocyte ratio (NLR) is a new predictor for cardiovascular risk and mortality. The SYNTAX score is an angiographic tool used in grading the complexity of coronary artery disease (CAD). However, its relation with CAD severity and complexity is not yet known. We hypothesized that NLR would be associated with a greater complexity of CAD as assessed using the SYNTAX score. Methods: This cross-sectional observational study included 106 patients who had undergone coronary angiography for stable angina pectoris and 69 patients who had normal coronary angiogram. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. The patients were classified two groups as CAD (-) (n=69) and CAD (+) (n=106), then patients in CAD (+) group were divided into 3 groups according to SYNTAX scores (SYNTAX score 1-22, 23-32, >32) as pointed in European Society of Cardiology (ESC) revascularization guideline. Statistical analysis was performed using the Mann-Whitney U and Kruskal-Wallis tests, and multiple logistic regression analysis was used to identify the independent predictors of complexity of CAD-SYNTAX score. Results: Patients with CAD had a significantly higher value of NLR [1.6 median (1.2-3.3 IQR) vs. 2.3 median (1.8-3.0 IQR) p<0.001]. The group with high SYNTAX scores (>32) more frequently had diabetes mellitus (DM), hypercholesterolemia (HL), were of older age, and also had significantly elevated NLR values [2.4 (1.3-2.6), 2.6 (2.3-3.9), 2.0 (1.5-2.6) p=0.006]. In univariate analysis, age, DM, HL, creatinine, neutrophil count and NLR were predictors of high SYNTAX score. In the multiple logistic regression analysis, only NLR [odds ratio (OR)=2.1, 95% confidence interval (CI) 1.2-3.8, p=0.09], was identified as independent predictor of a high SYNTAX score. Conclusion: NLR is a strong clinical laboratory value that is associated with presence and complexity of CAD. (Anadolu Kardiyol Derg 2013; 13: 662-7) Key words: Neutrophil -to-lymphocyte ratio, complexity, coronary artery disease, regression analysis, sensitivity, specificity Original Investigation Özgün Araşt›rma 662ÖZET Amaç: Nötrofil lenfosit oranı (NLO) kardiovasküler risk ve mortalite için yeni bir öngördürücüdür. SYNTAX skoru koroner arter hastalığı (KAH) karmaşıklığını derecelendirmede anjiyografik bir yöntemdir. NLO ile KAH varlığı ve karmaşıklığı arasındaki ilişki henüz ortaya konmamıştır. Biz SYNTAX skorunu kullanarak NLO ile KAH varlığı ve karmaşıklığı arasında daha güçlü bir ilişki olabileceği tezini öne sürdük. Yöntemler: Bu enine kesit gözlemsel çalışmaya 106 koroner anjiyografisi yapılmış stabil angina pectoris hastası ve 69 normal koronere sahip hastalar dahil edildi. Bazal NLO nötrofil sayısının lenfosit sayısına oranı olarak hesaplandı. Hastalar KAH olan ve olmayan şeklinde iki gruba ayrıldı. KAH grubu SYNTAX skoruna göre Avrupa Kardiyoloji Cemiyeti miyokardiyal girişim kılavuzuna dayanarak 3 gruba ayrıldı (23)(24)(25)(26)(27)(28)(29)(30)(31)(32) >32). İstatistiksel analiz Mann-Whitney U ve Kruskal-Wal...

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“…Obtaining information about SXScore before invasive diagnosis would give useful information on long-term risk stratification [3][4][5]16] and therefore possibly reduce the number of required invasive procedures. In selected cases with high SXScore and convenient anatomy the decision to perform CABG might even be made without ICA.…”

Section: Discussionmentioning

confidence: 99%

Coronary computed tomography angiography for the assessment of SYNTAX score

Wolny

Jastrzebski

Szubielski³

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: Coronary computed tomography angiography (CCTA) is applied in a growing number of clinical indications. This imaging modality is often regarded as a surrogate of invasive coronary angiography (ICA). In this paper we evaluate the applicability of CCTA alone in the assessment of the SYNTAX score. Aim:To evaluate the feasibility of calculating the SYNTAX score (SXScore) using CCTA alone instead of ICA.Methods: Ninety consecutive patients with multivessel or left main (LM) coronary artery disease diagnosed with ICA, in whom prior CCTA scan was available, were included in a post-hoc analysis. First, the SXScore was calculated twice in ten-week intervals by two experienced observers using ICA for each patient. Then the SXScore was calculated twice using CCTA following the same regimen for each patient. Weighted kappa statistic was used to assess the intra-modality and inter-modality reproducibility of the SXScore.Results: Ninety patients, aged 63.8 ± 8.9 years, 60% male, 64.4% with two-vessel disease, and 35.6% with three-vessel or LM disease met the inclusion criteria. 287 lesions were identified by ICA and 280 by CCTA (p = 0.56). Median total SXScore was 11.5 (10.2-14.0) as calculated by ) by CCTA (p < 0.001), and the results were moderately correlated (R = 0.38). Inter-modality agreement between ICA and CCTA for SXScore tertiles was moderate (kappa = 0.40). The intra-modality reproducibility of ICA and CCTA for SXScore tertiles was 0.47 and 0.51, respectively. Conclusions:Inter-modality agreement between CCTA and ICA for calculation of SXSscore is moderate but only slightly worse than intra-modality reproducibility for angiographic alone evaluation. Most of the observed variability can be assigned to the characteristic of the SXScore itself, not to the choice of imaging method. However, the application of CCTA for the assessment of SXScore should be used cautiously.

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Usefulness of the SYNTAX Score for Predicting Clinical Outcome After Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Disease

Cited by 205 publications

References 12 publications

Testing Endothelial Function and its Clinical Relevance

Testing Endothelial Function and its Clinical Relevance

Relation of neutrophil -to- lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study

Coronary computed tomography angiography for the assessment of SYNTAX score

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