Abstract

BackgroundSYNTAX Scores I (SSI) assesses the complexity of CAD; SYNTAX Score II (SSII) uses both SSI and other clinical variables, in estimation of 4 years mortality following both coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI) and gives recommendations for the best revascularization strategy in a specific patient. Our aim is to investigate the impact of both SYNTAX Scores on short-term outcome following CABG.ResultsProspectively, we studied 150 patients with multi-vessels coronary artery disease, referred to perform, elective primary isolated CABG. All cases performed on pump CABG with aortic cross clamping, then followed up for 90 days postoperatively, for onset of mortality from all causes, myocardial infarction (MI), stroke, mediastinitis, and need for renal replacement therapy (RRT).SSI showed a statistically significant association with in-hospital and 90 days mortality, MI, and mediastinitis (P = < 0.001, 0.015, 0.045 respectively); SSII showed a statistically significant association with in-hospital mortality and 90 days mortality and need for renal replacement therapy (P = 0.007, 0.043, 0.012 respectively); SSI is independent risk factor for overall mortality (OR 1.192, 95% CI 1.018–1.396) (P = 0.029) and MI (OR 1.182, 95% CI 1.016–1.375).ConclusionsSYNTAX Scores are good predictors of short-term outcome after CABG; increased SSI was associated with increased mortalities (in-hospital and total 90 days), MI and mediastinitis, increased SSII associated with increased mortalities (in-hospital and total 90 days), and need for RRT; SSI is independent risk factor for mortality and MI.

Highlights

  • SYNTAX Society of Thoracic Surgeons risk score (Score) I (SSI) assesses the complexity of Coronary artery disease (CAD); SYNTAX Score II (SSII) uses both Scores I (SSI) and other clinical variables, in estimation of 4 years mortality following both coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI) and gives recommendations for the best revascularization strategy in a specific patient

  • SYNTAX Score II recommended both CABG and PCI to 90 patients of our cohort (60%), CABG only for 46 (30.7%), while PCI only recommended for 14 patients (9.3%)

  • By following up these PCI recommended patients, we found among them one case had in-hospital mortality from myocardial infarction (MI)

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Summary

Introduction

SYNTAX Scores I (SSI) assesses the complexity of CAD; SYNTAX Score II (SSII) uses both SSI and other clinical variables, in estimation of 4 years mortality following both coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI) and gives recommendations for the best revascularization strategy in a specific patient. CABG is still the revascularization strategy of choice in the management of patients with left main (LM) disease, diabetic patients with multivessels disease (MVD), and patients with complex anatomy of coronary arteries As in these patients, CABG is associated with better long-term outcome, in the form of lower incidence of mortality and major adverse cardiac events [4,5,6]. There are many valid risk scores that used for this purpose; both EuroSCORE II and STS scores are effective and accurate in estimation of inhospital and 30 days mortality post cardiac surgery but sharing a common disadvantage of neglecting the anatomical complexity of the coronary arteries [7,8,9]

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