FACTORS ASSOCIATED WITH THE SEVERITY OF CORONARY ARTERY DISEASE ASSESSED BY THE SYNTAX SCORE IN PATIENTS WITH ACUTE CORONARY SYNDROME
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Abstract
Introduction: Acute coronary syndrome (ACS) remains a leading cause of mortality and disability. The SYNTAX score, derived from coronary angiograms, categorizes the severity of coronary lesions to facilitate the selection of appropriate revascularization strategies and predict clinical outcomes. This study aimed to identify factors associated with the complexity of coronary lesions as assessed by the SYNTAX score. These predictors will help physicians stratify patients’ risk during the initial emergency department assessment, ultimately reducing the time needed to determine the optimal revascularization strategy.
Methods: A cross-sectional study was conducted on 181 ACS patients who underwent invasive coronary angiography at the Interventional Cardiology Department of Nguyen Tri Phuong Hospital, Ho Chi Minh City, from February 2025 to June 2026. The primary outcome was a moderate-to-high SYNTAX score (≥ 23). Univariate and multivariate logistic regression analyses were performed to identify independent predictors and adjust for confounding factors.
Results: The mean age of the cohort was 67.1 ± 11.3 years, with 67.4% being male. Common cardiovascular risk factors included dyslipidemia (83.4%), hypertension (79.4%), smoking (54.6%), and diabetes mellitus (41.7%). Multivariate logistic regression analysis revealed that serum NT-proBNP levels, a history of diabetes, and smoking status were independent predictors for a SYNTAX score ≥ 23. Specifically, for every 1000 pg/mL increase in NT-proBNP, the risk of having a SYNTAX score ≥ 23 increased by 17.9% (OR = 1.179; 95% CI: 1,075 – 1,289; p < 0,001). Patients with comorbid diabetes mellitus had a 3.76-fold higher risk (OR = 3.758; 95% CI: 1.719 – 8.222; p = 0.001), and those with a history of smoking had a 4.36-fold higher risk (OR = 4.364; 95% CI: 1.541 – 12.357; p = 0.006).
Conclusion: Serum NT-proBNP levels, a history of diabetes mellitus, and smoking are independent predictors of moderate-to-high coronary artery lesion complexity (SYNTAX ≥ 23) in ACS patients.
Keywords
SYNTAX score, acute coronary syndrome, independent predictors
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References
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