Assessment of the SYNTAX score in the syntax study

Patrick W. Serruys, Yoshinobu Onuma, Scot Garg, Giovanna Sarno, Marcel van den Brand, Arie Pieter Kappetein, Nic Van Dyck, Michael Mack, David Holmes, Ted Feldman, Marie Claude Morice, Antonio Colombo, Eric Bass, Katrin Leadley, Keith D. Dawkins, Gerrit Anne van Es, Marie Angèle M. Morel, Friedrich W. Mohr

Research output: Contribution to journalArticle

340 Citations (Scopus)

Abstract

Aims: The SYNTAX™ score has been designed to better anticipate the risks of percutaneous or surgical revascularisation, taking into account the functional impact of the coronary circulation with all its anatomic components including the presence of bifurcations, total occlusions, thrombus, calcification, and small vessels. The purpose of this paper is to describe the baseline assessment of the SYNTAX™ score in the Syntax randomised trial, the corelab reproducibility, the potential difference in score assessment between the investigator and the corelab, and to ascertain the impact on one-year outcome after either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) in patients with complex coronary artery disease. Methods and results: To assess the reliability of Syntax™ scoring, 100 diagnostic angiograms from the Syntax trial were randomly selected and assessed independently by two observers. Intra-observer variability was assessed by analysing 91 sets of angiograms after an interval of at least eight weeks by one of the observers. Clinical outcomes in the randomised cohort of the Syntax trial up to one year are presented with stratification by tertile group of the SYNTAX™ score. The weighted kappa value for the inter-observer reproducibility on the global score was 0.45, while the intra-observer weighted kappa value was 0.59. The SYNTAX™ score as calculated by investigators consistently underscored the corelab score by 3.4 points. When the Syntax randomised cohort was stratified by tertiles of the SYNTAX™ score, there were similar or non-significantly different MACCE rates in those with low or intermediate scores; however in the top tertile the MACCE rate was greater in those receiving PCI compared to CABG. Conclusions: The SYNTAX™ score is a visual coronary score with an acceptable corelab reproducibility that has an impact on the one-year outcome of those having PCI, whereas it has no effect on the one-year outcome following surgical revascularisation. The SYNTAX™ score tool is likely to be useful in a wide range of patients with complex coronary disease.

Original languageEnglish (US)
Pages (from-to)50-56
Number of pages7
JournalEuroIntervention
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2009

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Percutaneous Coronary Intervention
Coronary Artery Bypass
Angiography
Research Personnel
Coronary Circulation
Observer Variation
Coronary Disease
Coronary Artery Disease
Thrombosis

Keywords

  • Complex lesions
  • Coronary artery bypass surgery
  • Percutaneous coronary intervention
  • SYNTAX score
  • SYNTAX study

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Serruys, P. W., Onuma, Y., Garg, S., Sarno, G., van den Brand, M., Kappetein, A. P., ... Mohr, F. W. (2009). Assessment of the SYNTAX score in the syntax study. EuroIntervention, 5(1), 50-56. https://doi.org/10.4244/EIJV5I1A9

Assessment of the SYNTAX score in the syntax study. / Serruys, Patrick W.; Onuma, Yoshinobu; Garg, Scot; Sarno, Giovanna; van den Brand, Marcel; Kappetein, Arie Pieter; Van Dyck, Nic; Mack, Michael; Holmes, David; Feldman, Ted; Morice, Marie Claude; Colombo, Antonio; Bass, Eric; Leadley, Katrin; Dawkins, Keith D.; van Es, Gerrit Anne; Morel, Marie Angèle M.; Mohr, Friedrich W.

In: EuroIntervention, Vol. 5, No. 1, 01.01.2009, p. 50-56.

Research output: Contribution to journalArticle

Serruys, PW, Onuma, Y, Garg, S, Sarno, G, van den Brand, M, Kappetein, AP, Van Dyck, N, Mack, M, Holmes, D, Feldman, T, Morice, MC, Colombo, A, Bass, E, Leadley, K, Dawkins, KD, van Es, GA, Morel, MAM & Mohr, FW 2009, 'Assessment of the SYNTAX score in the syntax study', EuroIntervention, vol. 5, no. 1, pp. 50-56. https://doi.org/10.4244/EIJV5I1A9
Serruys PW, Onuma Y, Garg S, Sarno G, van den Brand M, Kappetein AP et al. Assessment of the SYNTAX score in the syntax study. EuroIntervention. 2009 Jan 1;5(1):50-56. https://doi.org/10.4244/EIJV5I1A9
Serruys, Patrick W. ; Onuma, Yoshinobu ; Garg, Scot ; Sarno, Giovanna ; van den Brand, Marcel ; Kappetein, Arie Pieter ; Van Dyck, Nic ; Mack, Michael ; Holmes, David ; Feldman, Ted ; Morice, Marie Claude ; Colombo, Antonio ; Bass, Eric ; Leadley, Katrin ; Dawkins, Keith D. ; van Es, Gerrit Anne ; Morel, Marie Angèle M. ; Mohr, Friedrich W. / Assessment of the SYNTAX score in the syntax study. In: EuroIntervention. 2009 ; Vol. 5, No. 1. pp. 50-56.
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AU - Kappetein, Arie Pieter

AU - Van Dyck, Nic

AU - Mack, Michael

AU - Holmes, David

AU - Feldman, Ted

AU - Morice, Marie Claude

AU - Colombo, Antonio

AU - Bass, Eric

AU - Leadley, Katrin

AU - Dawkins, Keith D.

AU - van Es, Gerrit Anne

AU - Morel, Marie Angèle M.

AU - Mohr, Friedrich W.

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