Correlation between SYNTAX Score and Myocardial Ischemia as Assessed by SPECT Myocardial Perfusion Imaging in Patients Undergoing Coronary Interventions
Muneer Saif Abdulkhaleq Mohammed Alshameery
*
Cardiology Department, Faculty of Medicine, Al-Azhar University (Boys), Cairo, Egypt.
Islam Shawky Abd El-Aziz Seif El-Yazal
Cardiology Department, Faculty of Medicine, Al-Azhar University (Boys), Cairo, Egypt.
Mohamad Ahmad Mosaad Zaki
Cardiology Department, Faculty of Medicine, Al-Azhar University (Boys), Cairo, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Coronary artery disease (CAD) is a major cardiovascular health problem. Myocardial perfusion imaging (MPI), especially single-photon emission computed tomography (SPECT), provides valuable diagnostic and prognostic information after percutaneous coronary intervention (PCI). The Synergy Between PCI with TAXUS and Cardiac Surgery (SYNTAX) score evaluates coronary lesion complexity and predicts ischaemic burden and outcomes after revascularisation. The objective was to determine the correlation of the SYNTAX score with myocardial ischaemia measured by SPECT MPI among patients undergoing coronary interventions.
This prospective study was conducted in 85 patients undergoing coronary interventions. Each participant underwent clinical and local cardiac examination, together with laboratory testing comprising complete blood count (CBC), urea, serum creatinine, creatinine clearance, prothrombin time (PT), international normalised ratio (INR), and lipid profile.
SYNTAX I was significantly associated with myocardial ischaemia parameters, whereas SYNTAX II (PCI) was associated with SSS, SRS, SDS, and TPD (all P < 0.05). EF showed inverse correlations with SYNTAX I and SYNTAX II (PCI), whereas LDL showed no significant association. Patients with DM had higher SYNTAX I scores and TPD than those without DM (P < 0.05). SSS, SRS, SDS, and TPD differed significantly across SYNTAX I groups, whereas only SSS and SRS differed across SYNTAX II (PCI) groups. No significant associations were observed for SYNTAX II (CABG), HTN, dyslipidaemia, or smoking (P > 0.05).
SYNTAX I correlated with MPI parameters, while higher coronary complexity was associated with diabetes and reduced EF, supporting combined anatomical and functional assessment in CAD.
Keywords: Myocardial ischemia, myocardial perfusion imaging, coronary interventions, coronary artery disease