Authors

• Vedran Đambić — Medicinski Fakultet Osijek, Osijek, Hrvatska — ORCID: 0000-0001-6903-2439
• Ivica Bošnjak — Klinički bolnički centar Osijek, Osijek, Hrvatska — ORCID: 0000-0002-0223-4287
• Aleksandar Kibel — Medicinski Fakultet Osijek, Osijek, Hrvatska — ORCID: 0000-0001-7843-1079

Abstract

**Introduction**: Syntax score II (SS II) is an angiographic-clinical tool that allows an objective individualization of mortality prediction in patients suffering from multivessel coronary artery disease (CAD) (1). Multivessel CAD indicates the involvement of at least two epicardial coronary arteries and represents a local manifestation of atherosclerosis (2, 3). The aim is to examine whether dyslipidemia, hyperuricemia and the presence of diabetes have a positive correlation to higher SS II values. **Patients and Methods:** 72 participants with multiple CAD hospitalized during the period of October 1, 2015. to October 1, 2017 were included. The necessary data was obtained from the hospital information system (BIS) and the hospital archive. An online calculator was used to calculate the SS I for which an interpretation of the coronary angiogram is required, and then the SS II involving two anatomical (SS I, left main coronary artery involvement) and six clinical variables (age, gender, creatinine clearance, ejection fraction, presence of chronic obstructive pulmonary disease and peripheral vascular disease in anamnesis). **Results:** There is a significant positive correlation of high-density lipoprotein (HDL) concentrations, and the proportion of patients with low-density lipoprotein (HDL) levels above the reference values, with SS II percutaneous coronary intervention (PCI) (median 46.3; P = 0.04). The participants with lower LDL values have significantly elevated SS II coronary artery bypass graft (CABG) values (median 35.5; P = 0.04), but not SS II PCI. There is no significant correlation of total cholesterol and triglycerides with SS II PCI or SS II CABG. The participants with hyperuricemia have a significantly higher value of SS II PCI (median 43.7; P = 0.04), but not SS II CABG. Diabetes as a comorbidity is present in 32 (44%) participants who have a significantly elevated SS II PCI (median 43.4; P = 0.03), but not SS II CABG in comparison with non-diabetic participants. **Conclusion**: SS II is associated with some of the classic risk factors for atherosclerosis (uric acid, diabetes), while in our group of participants there is a surprising correlation of SS II with high HDL levels and low LDL levels.

DOI

Literature

1. Boukhris M, Abcha F, Tomasello SD, Giubilato S, Azzarelli S, Galassi AR. Residual SYNTAX score II: A combination of the assessment of the revascularization degree and the clinical evaluation after percutaneous coronary intervention. J Saudi Heart Assoc. 2018 Apr;30(2):158–9. https://doi.org/10.1016/j.jsha.2017.11.003
2. Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007 Apr 12;356(15):1503–16. https://doi.org/10.1056/NEJMoa070829
3. Al-Hijji M, El Sabbagh A, Holmes DR. Revascularization for Left Main and Multivessel Coronary Artery Disease: Current Status and Future Prospects after the EXCEL and NOBLE Trials. Korean Circ J. 2018 Jun;48(6):447–62. https://doi.org/10.4070/kcj.2018.0078