Widening clinical applications of the SYNTAX Score

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Health Services Research

Background:

• The SYNTAX Score is an established tool for assessing coronary artery disease complexity.
• It guides treatment decisions between coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI).
• The score is incorporated into European and US revascularization guidelines.

Purpose of the Study:

• To review the expanding clinical applications of the SYNTAX Score.
• To explore improvements in diagnostic accuracy and decision-making.
• To discuss future developments, including a functional SYNTAX Score.

Main Methods:

• Systematic review of literature on SYNTAX Score applications.
• Examination of studies incorporating functional lesion assessment.
• Analysis of the development and validation of SYNTAX Score II.
• Review of residual and post-CABG SYNTAX Scores for revascularization completeness.
• Discussion of ongoing research and clinical trials.

Main Results:

• The SYNTAX Score has been validated for identifying high-risk patients and guiding CABG vs. PCI decisions.
• New applications include integrating functional data and clinical variables (SYNTAX Score II) for personalized treatment.
• The score is used to assess revascularization completeness after PCI and CABG.

Conclusions:

• The SYNTAX Score and its derivatives are crucial for objective decision-making in complex coronary artery disease.
• Future developments aim for non-invasive functional assessment to further refine treatment strategies.
• The SYNTAX Score facilitates a heart team approach for optimal patient care.