Impact of CT Enhanced Syntax Score (Ctesx) on Grading Complexity of Coronary Artery Disease

Abstract

Purpose: The SYNTAX Score is a crucial tool to grade angiographic complexity and risk stratification of patients for revascularization. Excessive coronary calcification can lead to adverse outcomes after percutaneous coronary intervention (PCI), and it represents an essential part of SYNTAX score calculation. The sensitivity in detecting any CAC by CT is much higher than in ICA. Our purpose is to evaluate the impact of CT-enhanced calcium detection on SYNTAX score in the evaluation of complex coronary anatomy. Methodology: This study was conducted at Beni-suef University Hospital and National Heart Institute from December 2019 to January 2021. Fifty consecutive male patients were enrolled, Their Coronary CT Angiography showed significant MVD; then, conventional coronary angiography was done. The additive value, rather than the comparative value, of adding Calcification from CT to CA syntax score (CT enhanced SYNTAX (CTeSx)), was assessed regarding its impact on the classification of complexity. Findings: Using a CTeSX Vs CA Sx results in Lower Possibilities of Low Syntax group (39% vs 24%) (P-value <0.001) and a higher Possibilities of High Syntax score (23% vs 52% P-value 0.004 Recommendation: CTeSX results in a significant change in the percentage of all complexity categories with a higher possibility to categorize complex anatomy.