Functional (Re)Development of SYNTAX Score II 2020: Predictive Performance and Risk Assessment

Abstract

The present study investigates the prognostic value of the Syntax Score II 2020 corrected for flow-limiting lesions and its ability to better address treatment by benefit prediction among patients with left main or multivessel disease. We analyzed 1274 patients from the HALE-BOPP cohort and integrated the Syntax Score II 2020 with the result of the fractional flow reserve (FFR) evaluation. Absolute risk difference (ARD) between surgical and percutaneous revascularization was calculated for anatomic and functional Syntax Score II 2020 predicted mortality. The ARD allowed to stratify the population into two large categories: “coronary artery bypass graft (CABG) better” with ARD ≥ 4.5% and “CABG–percutaneous coronary intervention (PCI) equipoise” with ARD p p p < 0.01). The integration between Syntax Score II 2020 and physiology is feasible, and merging clinical, anatomic and functional data allows for better risk prediction and therapeutic guidance.

Keywords

• syntax score
• fractional flow reserve
• multivessel disease