Impact of CT Enhanced Syntax Score (Ctesx) on Grading Complexity of Coronary Artery Disease
DOI:
https://doi.org/10.47672/ajhmn.1035Keywords:
SYNTAX Score, Complex coronary anatomy, Calcification, Coronary CT.Abstract
Purpose: The SYNTAX Score is a crucial tool to grade angiographic complexity and risk stratification of patients for revascularization. Excessive coronary calcification can lead to adverse outcomes after percutaneous coronary intervention (PCI), and it represents an essential part of SYNTAX score calculation. The sensitivity in detecting any CAC by CT is much higher than in ICA. Our purpose is to evaluate the impact of CT-enhanced calcium detection on SYNTAX score in the evaluation of complex coronary anatomy.
Methodology: This study was conducted at Beni-suef University Hospital and National Heart Institute from December 2019 to January 2021. Fifty consecutive male patients were enrolled, Their Coronary CT Angiography showed significant MVD; then, conventional coronary angiography was done. The additive value, rather than the comparative value, of adding Calcification from CT to CA syntax score (CT enhanced SYNTAX (CTeSx)), was assessed regarding its impact on the classification of complexity.
Findings: Using a CTeSX Vs CA Sx results in Lower Possibilities of Low Syntax group (39% vs 24%) (P-value <0.001) and a higher Possibilities of High Syntax score (23% vs 52% P-value 0.004
Recommendation: CTeSX results in a significant change in the percentage of all complexity categories with a higher possibility to categorize complex anatomy.
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Garg, Scot, Giovanna Sarno, Hector M. Garcia-Garcia, Chrysafios Girasis, Joanna Wykrzykowska, Keith D. Dawkins, Patrick W. Serruys, and ARTS-II Investigators. "A new tool for the risk stratification of patients with complex coronary artery disease: the Clinical SYNTAX Score." Circulation: Cardiovascular Interventions 3, no. 4 (2010): 317-326.
Neumann, Franz-Josef, Miguel Sousa-Uva, Anders Ahlsson, Fernando Alfonso, Adrian P. Banning, Umberto Benedetto, Robert A. Byrne et al. "2018 ESC/EACTS Guidelines on myocardial revascularization." European heart journal 40, no. 2 (2019): 87-165.
Dehmer, Gregory J., Vinay Badhwar, Edmund A. Bermudez, Joseph C. Cleveland Jr, Mauricio G. Cohen, Richard S. D'Agostino, T. Bruce Ferguson Jr et al. "2020 AHA/ACC key data elements and definitions for coronary revascularization: a report of the American College of Cardiology/American Heart Association task force on clinical data standards (writing committee to develop clinical data standards for coronary revascularization)." Journal of the American College of Cardiology 75, no. 16 (2020): 1975-2088.
Abazid, Rami M., M. Obadah Kattea, Osama A. Smettei, Yasir Beshir, and Haitham Sakr. "Impact of coronary artery calcification on percutaneous coronary intervention and postprocedural complications." Journal of the Saudi Heart Association 29, no. 1 (2017): 15-22.
Tobis, Jonathan M., John Mallery, Don Mahon, Kenneth Lehmann, Paul Zalesky, James Griffith, James Gessert, Masahito Moriuchi, Michael McRae, and Mary-Lynn Dwyer. "Intravascular ultrasound imaging of human coronary arteries in vivo. Analysis of tissue characterizations with comparison to in vitro histological specimens." Circulation 83, no. 3 (1991): 913-926.
Agatston, Arthur S., Warren R. Janowitz, Frank J. Hildner, Noel R. Zusmer, Manuel Viamonte, and Robert Detrano. "Quantification of coronary artery calcium using ultrafast computed tomography." Journal of the American College of Cardiology 15, no. 4 (1990): 827-832.
van Dijk, Joris D., Mohammad S. Shams, Jan Paul Ottervanger, Mohamed Mouden, Jorn A. van Dalen, and Pieter L. Jager. "Coronary artery calcification detection with invasive coronary angiography in comparison with unenhanced computed tomography." Coronary Artery Disease 28, no. 3 (2017): 246-252.
Karthik, L., Gaurav Kumar, Tarun Keswani, Arindam Bhattacharyya, S. Sarath Chandar, and K. V. Bhaskara Rao. "Protease inhibitors from marine actinobacteria as a potential source for antimalarial compound." PloS one 9, no. 3 (2014): e90972.
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Copyright (c) 2022 Bassem Zarif, Ehab Cherif, Mohammad Shafiq, Marwa Ahmed Hanafy, Hesham B. Mahmoud
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