Utility of SYNTAX Score for predicting clinical outcomes after CTO-PCI

Abstract

BACKGROUND. Dealing with complex chronic total occlusions (CTOs) in patients undergoing percutaneous coronary intervention (PCI), it is important to evaluate not only the CTO lesion itself but also atherosclerotic lesions of the whole coronary artery tree. AIM. To evaluate the utility of the SYNTAX score in patients having CTO undergoing PCI. METHODS. This retrospective study included 72 consecutive patients with CTO lesions who underwent PCI. Primary endpoints were procedural failure and major adverse cardiac events (MACE) within 30 days. The SYNTAX and J-CTO scores were assessed before the procedures, and patients were divided into 2 groups according to SYNTAX criteria: high (> 22) and low (≤ 22). RESULTS. Procedural success was obtained in 86.1% of patients. Patients with a high SYNTAX score had significantly lower procedural success than those with a low SYNTAX score (72.6% v. 87.8%). There were 76% MACE in patients with high SYNTAX scores and 2.2% MACE in those with low scores. Both the SYNTAX and J-CTO scores had odds ratios of 1.39 (95% CI 1.03–1.81) and 3.31 (95% CI 1.12–9.43) for procedural failure. Higher SYNTAX scores were also an independent predictor of 30-day MACE after PCI (odds ratio 1.65, 95% Cl 1.54–2.26), though the J-CTO score failed to predict the development of MACE. CONCLUSION. The SYNTAX score appeared predictive of procedural failure in patients undergoing CTO-PCI. High SYNTAX scores were strongly associated with an increased risk of 30-day MACE.