SYNTAX  Scoring  In  Patients  with  Coronary  Artery  Disease and  Its  Effect on  Mode   of Revascularization , Single Center  Experience

B. Al Saffar, Hilal; FRCP,; FACC,; CABM,

	SYNTAX Scoring In Patients with Coronary Artery Disease and Its Effect on Mode of Revascularization , Single Center Experience
Journal of the Faculty of Medicine
Article 1, Volume 54, Issue 4, 2012, Pages 277-280
Authors
Hilal B. Al Saffar; ; ;
Abstract
Summary: Background: revascularization therapy for patients with left main (LM) and/or three vessel coronary disease is a matter of argument for long a time whether bypercutaneous coronary angiography orcoronary 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 Iraqi cardiac center and its effect on mode of revascularization. Patients and Method: Ninety nine patients who were referred to Iraqi center for heart disease from July to December 2010 withthe diagnosis of CAD 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 andSYNTAX score calculator was applied and the SYNTAX score was recorded.Patients were divided into two groups : group A , thosewho 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 prevalencewas DM (42.6%), high blood pressure (52.8 %), smoking (42.4%), hypercholesterolemia (43.4%) and prior MI (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. Iraqi 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. Key words: CAD, SYNTAX score, revascularization
Keywords
CAD; SYNTAX score; revascularization

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