RELATIONSHIP OF SERUM URIC ACID LEVELS AND ANGIOGRAPHIC SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME USING SYNTAX SCORE.

The GRACE score constitutes a useful tool for risk stratification in patients with acute coronary syndrome (ACS), while the SYNTAX score determines the complexity of coronary artery disease (CAD). This study sought to correlate these scores and assess the accuracy of the GRACE score in predicting the extent of CAD. A total of 539 patients with ACS undergoing coronary angiography were included in this analysis. The patients were classified into those with a SYNTAX score < 33 and a SYNTAX score ≥ 33. Spearman’s correlation and receiver operator characteristic analysis were conducted to investigate the role of the GRACE score as a predictor of the SYNTAX score. There was a significantly positive correlation between the SYNTAX and the GRACE scores (r = 0.32, p < 0.001). The GRACE score predicted severe CAD (SYNTAX ≥ 33) moderately well (the area under the curve was 0.595 (0.522–0.667)). A GRACE score of 126 was documented as the optimal cut-off for the prediction of a SYNTAX score ≥ 33 (sensitivity = 53.5% and specificity = 66%). Therefore, our study reports a significantly positive correlation between the GRACE and the SYNTAX score in patients with ACS. Notably, NSTEMI patients with a high-risk coronary anatomy have higher calculated GRACE scores. A multidisciplinary approach by a heart team could possibly alter the therapeutic approach and management in patients presenting with ACS and a high calculated GRACE score.

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The Association Between Serum Procalcitonin Levels and Severity of Coronary Artery Disease Assessed by SYNTAX Score in Patients With Acute Coronary Syndrome

Angiology ◽

10.1177/0003319716638239 ◽

2016 ◽

Vol 68 (1) ◽

pp. 40-45 ◽

Cited By ~ 13

Author(s):

Ahmet Göktuğ Ertem ◽

Tolga Han Efe ◽

Çağrı Yayla ◽

Mehmet Kadri Akboğa ◽

Burak Açar ◽

...

Keyword(s):

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Inflammatory Marker ◽

High Sensitivity ◽

Cross Sectional Study ◽

Syntax Score ◽

Cross Sectional ◽

Coronary Syndrome ◽

Artery Disease

The SYNTAX score (SX score) is a useful score for assessing the severity of coronary artery disease (CAD). Previous studies have demonstrated a close relationship between SX score and inflammation. Procalcitonin (PCT) is an early inflammatory marker, especially during sepsis. Thus, in this study, we aimed to investigate the relationship between SX score and serum PCT levels. A total of 545 patients were enrolled in this prospective cross-sectional study and were divided into 2 subgroups, according to their SX score. Serum PCT and high-sensitivity C-reactive protein levels were measured. Serum PCT levels were higher in the high SX score group compared to the low–intermediate SX score group ( P < .001). Serum PCT levels were an independent predictor of a high SX score in patients with acute coronary syndrome ( P = .001). As patients with a higher SX score had increased serum PCT levels on admission, serum PCT may be useful for identifying patients with severe CAD.

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Association of Uric Acid and C-reactive Protein with the Severity of Coronary Artery Disease Using SYNTAX Score and Clinical SYNTAX Score

The Heart Surgery Forum ◽

10.1532/hsf.2397 ◽

2019 ◽

Vol 22 (3) ◽

pp. E247-E252 ◽

Cited By ~ 1

Author(s):

Yu Xing ◽

Jing-Tao Guo ◽

Lu-Yue Gai ◽

Bo Liu ◽

Dong-Lei Luo

Keyword(s):

Coronary Artery Disease ◽

Uric Acid ◽

Coronary Artery ◽

Serum Uric Acid ◽

Fasting Glucose ◽

Syntax Score ◽

C Reactive Protein ◽

Reactive Protein ◽

Artery Disease ◽

Serum Crp

Background: The SYNTAX score (SXscore), an anatomical-based scoring tool reflecting the complexity of coronary anatomy, has been associated with the mortality and prognosis of coronary artery disease (CAD). Clinical SYNTAX score (CSS), incorporating clinical factors further augmented the utility of the SXscore to longer-term risk. C-reactive protein (CRP) is related to SXscore. Serum uric acid (UA) is associated with atherosclerosis and CAD. However, serum uric acid combined with CRP may better predict the SXscore and CSS. Methods: A total of 208 patients (mean age 57.82 ± 9.39 years) with chest pain were included in this study. All selected subjects underwent coronary artery angiography and blood test. The relationship between serum UA, CRP and SXscore, and CSS were analyzed. Results: Age and CRP had a positive correlation with SXs and CSS. DM and fasting glucose correlated with SXscore and CSS respectively. In multivariate regression, serum UA, age, fasting glucose, and body mass index (BMI) were significant discriminant factors of high CSS. The predictive accuracy of CRP for SXscore >0 and high CSS using receiver operator characteristic curves was set at the cut off point of 0.205 mg/dL and 0.145 mg/dL respectively, (sensitivity 70.9% and 98%, specialty 48% and 23.2%). Conclusion: Serum CRP is correlated with SXscore and CSS, serum UA is independently associated with CSS. CRP predicts high CSS at a lower level than it predicts SXscore. Thus, serum CRP combined with serum UA may be useful to predict SXscore and CSS.

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Admission Heart Rate Is Associated With Coronary Artery Disease Severity and Complexity in Patients With Acute Coronary Syndrome

Angiology ◽

10.1177/0003319719832376 ◽

2019 ◽

Vol 70 (8) ◽

pp. 774-781 ◽

Cited By ~ 1

Author(s):

Xiaoteng Ma ◽

Zhijian Wang ◽

Jianlong Wang ◽

Fang Liu ◽

Dai Zhang ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Disease Severity ◽

Plaque Burden ◽

Syntax Score ◽

Coronary Syndrome ◽

Coronary Artery Disease Severity ◽

Artery Disease

We evaluated the relationship between admission heart rate (HR) and coronary artery disease severity and complexity in patients with acute coronary syndrome (ACS). A total of 884 patients (mean age 59 [11] years, 24.7% female) who underwent coronary angiography for ACS and were treated with primary or selective percutaneous coronary intervention were included in this cross-sectional study. The measurement of admission HR was based on the first available resting electrocardiogram after admission. The SYNTAX score (SS) was calculated. Patients with an SS ≤ 22 (n = 538) were classified as the low SS group and those with an SS > 22 (n = 346) were classified as the intermediate-to-high SS group. Admission HR was greater in the intermediate-to-high SS group compared with the low SS group (75 [10] bpm vs 67 [8] bpm, P < .001). Admission HR was positively and significantly correlated with the SS ( r = 0.475, P < .001). After multivariate analysis, admission HR (per 1 standard deviation, ie, 10 bpm) remained an independent predictor of intermediate-to-high SS (odds ratio: 3.135, 95% confidence interval: 2.538-3.873, P < .001). Admission HR is independently and positively associated with the SS. Thus, elevated admission HR may be useful to identify patients with ACS with a high coronary atherosclerotic plaque burden.

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Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Studies in Logic Grammar and Rhetoric ◽

10.1515/slgr-2015-0040 ◽

2015 ◽

Vol 43 (1) ◽

pp. 33-48 ◽

Cited By ~ 4

Author(s):

Magdalena Babińska ◽

Jerzy Chudek ◽

Elżbieta Chełmecka ◽

Małgorzata Janik ◽

Katarzyna Klimek ◽

...

Keyword(s):

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Uric Acid ◽

Coronary Artery ◽

Cox Regression ◽

Proportional Hazard ◽

Proportional Hazard Assumption ◽

Risk Of Death ◽

Coronary Syndrome ◽

Artery Disease

Abstract The aim of this study was to evaluate the possibility of incorrect assessment of mortality risk factors in a group of patients affected by acute coronary syndrome, due to the lack of hazard proportionality in the Cox regression model. One hundred and fifty consecutive patients with acute coronary syndrome (ACS) and no age limit were enrolled. Univariable and multivariable Cox proportional hazard analyses were performed. The proportional hazard assumptions were verified using Schoenfeld residuals, χ2 test and rank correlation coefficient t between residuals and time. In the total group of 150 patients, 33 (22.0%) deaths from any cause were registered in the follow-up time period of 64 months. The non-survivors were significantly older and had increased prevalence of diabetes and erythrocyturia, longer history of coronary artery disease, higher concentrations of serum creatinine, cystatin C, uric acid, glucose, C-reactive protein (CRP), homocysteine and B-type natriuretic peptide (NT-proBNP), and lower concentrations of serum sodium. No significant differences in echocardiography parameters were observed between groups. The following factors were risk of death factors and fulfilled the proportional hazard assumption in the univariable model: smoking, occurrence of diabetes and anaemia, duration of coronary artery disease, and abnormal serum concentrations of uric acid, sodium, homocysteine, cystatin C and NT-proBNP, while in the multivariable model, the risk of death factors were: smoking and elevated concentrations of homocysteine and NT-proBNP. The study has demonstrated that violation of the proportional hazard assumption in the Cox regression model may lead to creating a false model that does not include only time-independent predictive factors.

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V-FAT study – A correlation between novel markers of obesity and coronary artery disease severity assessed by Syntax score in patients presenting with acute coronary syndrome

Indian Heart Journal ◽

10.1016/j.ihj.2020.07.007 ◽

2020 ◽

Vol 72 (5) ◽

pp. 448-450

Author(s):

Anurag Bahekar ◽

Varghese George ◽

Kiran Jacob ◽

Sultan R. Salih ◽

Ancy Thannikkal Joseph ◽

...

Keyword(s):

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Disease Severity ◽

Syntax Score ◽

Coronary Syndrome ◽

Coronary Artery Disease Severity ◽

Artery Disease

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The relationship between IL-6 levels and the angiographic severity of coronary artery disease following percutaneous coronary intervention in acute coronary syndrome patients

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02406-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yang Ling ◽

Hairong Weng ◽

Shengxing Tang

Keyword(s):

Coronary Artery Disease ◽

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Area Under The Curve ◽

Coronary Intervention ◽

Syntax Score ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

Artery Disease

Abstract Background The present investigation was developed for the exploration of the association between IL-6 levels and acute coronary syndrome (ACS) findings upon angiographic evaluation. Methods A retrospective review of 346 patients suffering from chest discomfort that underwent coronary angiography was performed. The SYNergy between Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score (SS) and SS II were used to gauge ACS severity, with ACS patients being stratified into two groups based on an SS value of 22 and the median SS II value. Associations between IL-6 levels and SS or SS II values were assessed through Spearman's correlation analyses, and independent predictors of intermediate-high SS or high SS II were identified via a multivariate logistic regression approach. A receiver operating characteristic (ROC) curve was employed to explore of the predictive value of IL-6 levels. Results IL-6 was positively correlated with both SS (r = 0.479, P < 0.001) and SS II (r = 0.305, P < 0.001). Moreover, IL-6 levels were independently predictive of intermediate-high SS and high SS II values. ROC curves further demonstrated that IL-6 was able to predict intermediate-high SS and high SS II, with area under the curve (AUC) values of 0.806 and 0.624, respectively. Conclusion IL-6 levels are closely linked to the extent of coronary artery disease in ACS patients undergoing percutaneous coronary intervention. IL-6 levels may thus serve as a valuable and non-invasive biomarker of high-risk ACS patients.

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