Coronary lesion complexity assessed by SYNTAX score in 256-slice dual-source MDCT angiography

Area of Science:

• Cardiovascular imaging
• Interventional cardiology
• Radiology

Background:

• The SYNTAX Score (SS) is crucial for grading coronary artery disease (CAD) complexity in patients requiring revascularization.
• Noninvasive SS determination before invasive coronary angiography (ICA) could enhance patient management strategies.

Purpose of the Study:

• To evaluate the agreement between SS derived from ICA and SS derived from multidetector computed tomography (MDCT) angiography.
• To assess the diagnostic effectiveness of SS calculated from MDCT (SS-MDCT) compared to SS from ICA (SS-ICA).

Main Methods:

• 108 patients underwent both MDCT and ICA within 14 days.
• SS was calculated for both imaging modalities.
• Spearman's rank correlation and Bland-Altman analysis were used to compare SS-MDCT and SS-ICA.

Main Results:

• Moderate agreement was observed between SS-ICA and SS-MDCT (mean SS-MDCT=14.5, mean SS-ICA=15.9).
• Significant correlation was found in the low SS group (r=0.63, P=0.043), but not in the high SS group (r=0.036, P=0.677).
• Inter-test agreement was at least moderate, with fair agreement for thrombotic and bifurcation lesions.

Conclusions:

• SS-MDCT, using adapted SS-ICA parameters, demonstrated comparable precision to SS-ICA.
• MDCT assessment of SS showed particular effectiveness in the low SS subgroup, suggesting its utility in noninvasive CAD complexity evaluation.