Prognostic value of SYNTAX score based on coronary computed tomography angiography

Background The long-term prognostic value of the computed tomography (CT)-based SYNTAX score has not yet been investigated. The aim of our study was to investigate the prognostic value of the CT-SYNTAX score in predicting major adverse cardiac events (MACEs) in populations who underwent both coronary computed tomography (CCTA) and invasive coronary angiography (ICA), compared with prognostic values of coronary artery disease (CAD) findings on CCTA and the ICA-based SYNTAX score. Methods We retrospectively included 339 patients (213 men, mean age of 63.8 ± 9.45 years) with suspected CAD who underwent CCTA and ICA. SYNTAX score was obtained based on both CCTA and ICA. Follow-up clinical outcome data regarding composite MACEs were obtained. Cox proportional hazard models were developed to predict MACEs based on clinical variables, number of CAD vessels, and SYNTAX scores based on CCTA and ICA. The time-dependent receiver operating characteristic curve method was used, and the integrated area under the curve (iAUC) was calculated to compare the predictive prognosis of the models. Results During the median follow-up of 1374 days, there were 30 MACEs. In multivariate Cox regression adjusted for clinical variables, SYNTAX score group 4 ( 33) on CCTA and SYNTAX score groups 3 (23-32) and 4 ( 33) on ICA showed increased hazard ratios for MACEs compared to SYNTAX score group 1 (0). CT-SYNTAX score demonstrated no significant difference in iAUC compared with ICA-SYNTAX score and the number of vessels of CAD on CCTA. Conclusions CT-SYNTAX score can be a useful method for non-invasively predicting MACEs, especially in patients with complex CAD.