SYNTAX Score II Is Associated with Mortality after Isolated Coronary Artery Bypass Grafting

Background: SYNTAX Score II has been internally and externally validated according to predictive capability for mortality rates after coronary artery bypass grafting mainly in left-main and multivessel coronary artery disease.

Method: A total of 967 consecutive patients with elective isolated coronary artery bypass grafting have been retrospectively analyzed. SYNTAX Score I and II as well as follow-up data regarding 4-year mortality rate have been assessed for all patients. Kaplan–Meier curves, multivariate Cox-regression analysis and receiver operating characteristic curve have been constructed.

Results: Kaplan–Meier curve shows correlation between high SYNTAX Score II values and impaired 4-year overall survival (log-rank: p = 0.000275). High SYNTAX Score I values do not show this correlation (log-rank: p = 0.125). In multivariate Cox-regression analysis, independent factors (from the components of SYNTAX Score II) for impaired survival are high age (per 10 years) (HR: 1.606, 95% CI: 1.138–2.267, p = 0.007), low creatinine clearance (per 10 mL/min/1.73 m²) (HR: 0.856, 95% CI: 0.759–0.965, p = 0.011), low left ventricular ejection fraction (per 10%) (HR: 0.741, 95% CI: 0.615–0.894, p = 0.002), and the presence of chronic obstructive pulmonary disease (HR: 3.132, 95% CI: 1.323–7.415, p = 0.009). Receiver operating characteristic curve evaluating predictive capability of SYNTAX Score II regarding 4-year mortality shows an area under the curve of 0.679 (CI: 0.614–0.744).

Conclusion: High SYNTAX Score II values are statistically significant associated with 4-year mortality after elective isolated coronary artery bypass grafting. There is no correlation between high SYNTAX Score I values and 4-year mortality. Receiver operating characteristic curve shows acceptable predictive capability of SYNTAX Score II regarding 4-year mortality.

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Artikel online veröffentlicht:
28. Januar 2023