Editorial comment: SYNTAX score II 2020 as a tool for decision making on revascularization strategy in high-risk patients with complex coronary artery disease.

Abstract

Key points SYNTAX Score II 2020 outperforms both the anatomical SYNTAX Score and SYNTAX Score II in terms of predicting all‐cause mortality during long‐term follow‐up among patients with complex coronary artery disease (left main coronary artery disease, three‐vessel disease, or both) and chronic renal insufficiency undergoing percutaneous coronary intervention. A predicted all‐cause mortality of the SYNTAX Score II 2020 >7% significantly adversely affected the observed all‐cause mortality in patients with complex coronary artery disease and chronic renal insufficiency undergoing percutaneous coronary intervention. For prospective validation of the SYNTAX score II 2020 model in patients with complex coronary artery disease, particularly those with moderate‐to‐severe chronic renal insufficiency (eGFR <60 mL/min/1.73m2), further adequately powered, randomized trials of percutaneous coronary intervention versus coronary artery bypass graft surgery must be conducted, with long‐term follow‐up.