Impact of SYNTAX Score on In-hospital Outcome after Primary Percutaneous Coronary Intervention

  • Md Shariful Islam Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Md Afzalur Rahman Professor and Director, National Institute of Cardiovascular Diseases, Dhaka
  • Abdul Wadud Chowdhury Professor and Head, Department of Cardiology, Dhaka Medical College, Dhaka
  • Sayed Nasir Uddin Professor, National Institute of Cardiovascular Diseases, Dhaka
  • Nupur Kar Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Kajal Kumar Karmakar Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Mohammad Ullah Firoze Associate Professor, Department of Cardiology, Manikganj Medical College, Manikganj
  • Mohammad Arifur Rahman Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Monir Hossen Khan Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Md Nure Alam Ashrafi Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Muhammad Ruhul Amin Emergency medical officer, Shahid Ziaur Rahman Medical College Hospital, Bogra
  • Md Minhaj Arefin Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka
  • Fathima Aaysha Cader Assistant Registrar, Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka
Keywords: SYNTAX score, Primary PCI, STEMI

Abstract

Background: Limited contemporary data exist regarding the impact of SYNTAX score on in-hospital outcomes undergoing primary percutaneous coronary intervention(PCI) in acute STEMI patients.

Objectives: To evaluate the significance of the SYNTAX score for predicting in- hospital outcome after primary PCI in patient with acute STEMI.

Methods: This cohort study was conducted in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from September, 2015 to September, 2016. 42 patients with acute STEMI who underwent primary PCI were considered for the study. But 2 patients were excluded from the study due to failure of primary PCI. The patients were divided into two groups: Group I (low SYNTAX score d”22) and Group II (high Syntax score > 22). The Syntax score of all patients were calculated from an initial coronary angiogram before primary PCI. In-hospital outcome was observed in between two groups.

Results: Among traditional cardiovascular risk factors diabetes was significantly more prevalent in the Group II than Group I ( 82.4% vs 34.8%, p  0.003). Angiographic profile revealed maximum (69.6% vs 17.6%) culprit lesion in LAD artery in Group I and maximum culprit lesion (64.7% vs 21.7%) in RCA in Group II, these were the statistically significant between Group I and Group II (P<0.05). The high SYNTAX score group had lower TIMI 3 (76.47% vs 91.3%, p  0.03) compared to the low SYNTAX score group. But there were no significant difference in complications as arrhythmia (2.5% vs 0%), cardiogenic shock (2.5% vs 0%), heart failure (5% vs 2.5%) and mortality (5%vs 0%) between high and low SYNTAX score. Multivariate logistic regression analysis revealed SYNTAX score (OR = 5.95, p  0.001) was an independent predictor of in-hospital outcome in patients under going primary PCI. Performance test of SYNTEX score in the setting of Primary PCI outcome showed positive predictive value 83%.

Conclusions: SYNTAX score was an independent variable that can predict in-hospital outcomes of patients with acute STEMI undergoing primary PCI.

Bangladesh Heart Journal 2018; 33(2) : 121-125

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Author Biographies

Md Shariful Islam, Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Abdul Wadud Chowdhury, Professor and Head, Department of Cardiology, Dhaka Medical College, Dhaka

Department of Cardiology

Nupur Kar, Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Kajal Kumar Karmakar, Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Mohammad Ullah Firoze, Associate Professor, Department of Cardiology, Manikganj Medical College, Manikganj

Department of Cardiology

Mohammad Arifur Rahman, Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Monir Hossen Khan, Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Md Nure Alam Ashrafi, Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Md Minhaj Arefin, Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka

Department of Cardiology

Fathima Aaysha Cader, Assistant Registrar, Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka

Department of Cardiology

Published
2018-12-28
How to Cite
Islam, M. S., Rahman, M. A., Chowdhury, A., Uddin, S., Kar, N., Karmakar, K., Firoze, M. U., Rahman, M. A., Khan, M., Ashrafi, M. N., Amin, M. R., Arefin, M. M., & Cader, F. (2018). Impact of SYNTAX Score on In-hospital Outcome after Primary Percutaneous Coronary Intervention. Bangladesh Heart Journal, 33(2), 121-125. https://doi.org/10.3329/bhj.v33i2.39308
Section
Original Articles