Can Syntax Score predict angiographically visible distal embolization during primary percutaneous coronary...

Area of Science:

• Interventional Cardiology
• Cardiovascular Research
• Clinical Medicine

Background:

• Primary percutaneous coronary intervention (PPCI) is standard for ST-elevation myocardial infarction (STEMI).
• Achieving normal myocardial perfusion post-PPCI remains a challenge for some STEMI patients.
• Angiographically visible distal embolization (AVDE) can compromise outcomes.

Purpose of the Study:

• To identify angiographic and procedural predictors of AVDE during PPCI.
• To assess the impact of AVDE on mid and long-term mortality.

Main Methods:

• A cohort of 465 STEMI patients undergoing PPCI was analyzed.
• Patients were categorized into groups with (n=61) and without (n=404) AVDE based on intra-procedural angiograms.

Main Results:

• Univariate analysis identified longer stent length, higher balloon diameter, low Syntax Score (SxS), low left ventricular ejection fraction (LVEF), high neutrophil/lymphocyte ratio, and chronic renal failure as potential AVDE predictors.
• Multivariate analysis confirmed stent length, LVEF, and low SxS as significant predictors of AVDE.

Conclusions:

• Low Syntax Score, longer stent length, and low LVEF are independent predictors of AVDE in STEMI patients undergoing PPCI.
• The association of low SxS with AVDE suggests a link to high thrombus burden and plaque composition, rather than lesion complexity.