SYNTAX Score on Procedural Outcome among Patient Undergoing Primary Percutaneous Coronary Intervention

  • Md Shariful Islam Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Md Afzalur Rahman Professor and Director, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Abdul Wadud Chowdhury Professor and Head, Department of Cardiology, Dhaka Medical College, Dhaka, Bangladesh
  • Mohsin Ahmed Associate Professor, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Kajal Kumar Karmakar Associate Professor, Department of Cardiology National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Mohammad Ullah Firoz Associate Professor, Department of Cardiology, Manikganj Medical College, Manikganj, Bangladesh
  • Mohammad Arifur Rahman Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Md Mosharul Haque Junior Consultant.(card),UHC,Beanibazar,Sylhet, Bangladesh
  • Mohammad Sadaqul Islam Sikdar Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Ashrafuzzaman Tamal Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Abul khair Md Rezawanul Islam OSD, DGHS, attachment National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Muhammad Ruhul Amin Emergency medical officer, Shahid Ziaur Rahman Medical College Hospital, Bogra, Bangladesh
  • Abeeda Tasnim Reza Medical Officer, National Heart Foundation, Dhaka, Bangladesh
  • F Aaysha Cader Register and specialist, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
Keywords: SYNTAX score, Primary PCI, STEMI

Abstract

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

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

Methods: This perspective observational 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. Procedural outcome was observed in between two groups.

Results: Among study patients 57.5% were in SYNTAX score d”22 (Group I) and 42.5% were in SYNTAX score >22 (Group II). 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 ejection fraction (47.8±5.1 vs. 54.4±4.3, p= 0.04), lower TIMI flow 3 rate (76.47% vs 91.3%, p= 0.03 ) greater rate of MACE (29.4% vs. 4.3%, p=0.041), lower procedural success rate ( 76.47 vs. 91.3%, p= 0.046) compared to the low SYNTAX score group. ROC curve showed 77% sensitivity and 32% specificity for SYNTAX score when cut off value was 22 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 procedural outcomes

Bangladesh Heart Journal 2019; 34(1) : 5-10

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Abstract
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Published
2019-06-25
How to Cite
Islam, M. S., Rahman, M. A., Chowdhury, A., Ahmed, M., Karmakar, K., Firoz, M. U., Rahman, M. A., Haque, M. M., Sikdar, M. S., Tamal, A., Islam, A. khair, Amin, M. R., Reza, A., & Cader, F. (2019). SYNTAX Score on Procedural Outcome among Patient Undergoing Primary Percutaneous Coronary Intervention. Bangladesh Heart Journal, 34(1), 5-10. https://doi.org/10.3329/bhj.v34i1.41902
Section
Original Articles