Syntax score calculation with Multislice Computed Tomographic Angiography in comparison to invasive coronary angiography

Abstract

The aim was to study the feasibility of syntax score calculation with Multislice Computed Tomographic Angiography (MSCTA). Methods: Syntax score was calculated and compared for 91 consecutive patients underwent MSCTA and Invasive coronary angiography (ICA). Results: MSCTA for the diagnosis of >50 % stenosis per coronary artery showed that MSCTA had a specificity, sensitivity, specificity, negative predictive value and accuracy of 92.2% (217/235), 97.1% (125/129), 98.2% (217/221), and 94.3% (364/386) respectively. Agreement between modalities was high with a kappa of 0.74. There was a positive correlation between MSCTA and ICA Syntax scores (r = 0.73, p = 0.000). The mean Syntax score was 15.8 ± 7.16 for ICA versus 16.3 ± 7.6 for MSCTA (Kappa of Cohen 0.66, p = 0.000). The Bland–Altman plot revealed that the estimated bias was 1.9 ± 3.4 and the most bias occurred with a higher syntax score. Lesions per patient were more identified with MSCTA than ICA (2.5 ± 1.4 vs. 1.9 ± 1.1, p < 0.001), with a good level of agreement (kappa = 0.65). Syntax score per lesion was similar with a high level of agreement (6.3 ± 5.8 vs. 6.0 ± 4.8, kappa = 0.74, p < 0.001). Calcified lesions were identified to a similar extent (28 vs. 26 cases) with a fair level of agreement (kappa = 0.42). Lesions identified with both techniques showed a higher level of agreement than the total score (6.5 ± 4.8 for MSCTA vs. 6.9 ± 6.3 for ICA, p < 0.05), kappa = 0.76. Conclusion: MSCTA showed a good level of agreement with ICA in syntax score calculation.

Keywords

• Syntax score
• MSCTA
• Invasive coronary angiography