Does SYNTAX score II predict poor myocardial perfusion in ST-segmen.

Area of Science:

• Cardiology
• Interventional Cardiology
• Myocardial Infarction Research

Background:

• SYNTAX score II (SS-II) predicts outcomes in coronary artery disease but its role in ST-segment elevation myocardial infarction (STEMI) is unclear.
• Poor myocardial perfusion, indicated by myocardial blush grade (MBG) 0/1, negatively impacts STEMI prognosis after primary percutaneous coronary intervention (pPCI).

Purpose of the Study:

• To evaluate the prognostic value of SS-II in STEMI patients undergoing pPCI.
• To investigate the relationship between SS-II and MBG 0/1 in this patient population.

Main Methods:

• A total of 477 STEMI patients treated with pPCI were analyzed.
• SYNTAX score II and myocardial blush grade (MBG) were assessed; MBG was categorized as 0/1 (poor perfusion) or 2/3 (normal perfusion).
• Patients were stratified into three SS-II tertiles: low (≤20), intermediate (20-26), and high (≥26).

Main Results:

• The high SS-II tertile showed a significantly higher incidence of MBG 0/1 (46.1%) compared to intermediate (32.1%) and low (21.8%) tertiles (p < 0.001).
• Multivariate analysis confirmed SS-II as an independent predictor of MBG 0/1 (HR 1.084, p < 0.001).
• An SS-II cutoff value of >24 demonstrated optimal prediction for MBG 0/1 with 66% sensitivity and 54% specificity.

Conclusions:

• Elevated SS-II is an independent predictor of poor myocardial perfusion (MBG 0/1) in STEMI patients following pPCI.
• The SS-II may serve as a valuable tool for risk stratification in STEMI patients undergoing pPCI.