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The relationship between H2FPEF and SYNTAX scores in patients with non-ST elevation myocardial infarction
Emrah Bayam1, Macit Kalçık2, Burak Öztürkeri1
1Depertament of Cardiology, University of Medical Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey.
Insights
The H2FPEF score may help estimate coronary artery disease (CAD) complexity in non-ST elevation myocardial infarction (NSTEMI) patients. A high H2FPEF score correlates with a high SYNTAX score, indicating more severe CAD.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- The Synergy between Percutaneous Coronary Intervention (SYNTAX) score assesses coronary artery disease (CAD) extent and complexity.
- The H2FPEF score differentiates heart failure with preserved ejection fraction (HFpEF) from other dyspnea causes.
Purpose of the Study:
- To investigate the relationship between the H2FPEF score and the SYNTAX score in patients with non-ST elevation myocardial infarction (NSTEMI).
Main Methods:
- 282 NSTEMI patients undergoing coronary angiography were analyzed.
- H2FPEF scores were calculated on admission; SYNTAX scores evaluated CAD severity and extent.
- Coronary angiography was performed within 2 days of admission.
Main Results:
- Patients with high SYNTAX scores had higher mean H2FPEF scores and more comorbidities (diabetes, hypertension, atrial fibrillation), with lower LVEF.
- High H2FPEF score (OR: 3.61) and low LVEF (OR: 0.94) were independent predictors of high SYNTAX score.
- An H2FPEF score cutoff of 2.5 predicted high SYNTAX score with 80% sensitivity and 82.5% specificity (AUC: 0.890).
- A moderate positive correlation (r=0.694) was found between H2FPEF and SYNTAX scores.
Conclusions:
- A high H2FPEF score is associated with a high SYNTAX score in NSTEMI patients.
- The H2FPEF score may serve as a tool to estimate CAD extent and complexity in NSTEMI patients.
Background:
The Synergy between Percutaneous Coronary Intervention (SYNTAX) score, has been used to estimate the extent and complexity of coronary artery disease (CAD). The H2FPEF score enables robust discrimination of heart failure with preserved ejection fraction (HFpEF) from non-cardiac aetiologies of dyspnea. In the present study, we aimed to investigate the relationship between H2FPEF and SYNTAX scores in patients with non-ST elevation myocardial infarction (NSTEMI).
Method:
Two hundred eighty two consecutive patients with NSTEMI who underwent coronary angiographic examination were enrolled in this study. The H2FPEF score was calculated for each patient on admission. All patients underwent coronary angiography within 2 days following their admission. The SYNTAX scoring system was used to evaluate the severity and extent of CAD.
Results:
The mean H2FPEF Score [3(2-4) vs 1(0.5-1.5), p < .001] and the frequencies of diabetes mellitus, hypertension and, atrial fibrillation were significantly higher and LVEF was significantly lower in patients with high SYNTAX score. High H2FPEF Score (OR: 3.61, 95%CI: 2.64-4.93; p = .001) and low left ventricular ejection fraction (OR: 0.94, 95%CI: 0.89-0.98; p = .013) were found to be independent associates for high SYNTAX score. H2FPEF Score above a cut-off level of 2.5 predicted high SYNTAX score with a sensitivity of 80% and a specificity of 82.5% (AUC: 0.890; 95%CI: 0.848-0.931; p < .001). There was a significant and moderate positive correlation between H2FPEF and SYNTAX Scores (r = 0.694, p < .001).
Conclusion:
High H2FPEF score may be associated with high SYNTAX score and may be used to estimate the extent and complexity of CAD in NSTEMI patients.
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