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Accuracy of computed tomography for selecting the revascularization method based on SYNTAX score II

  • Cardiac
  • Published:
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Abstract

Objectives

The application of SYNTAX score II based on coronary CT angiography (CCTA) for selecting further treatment options has not been studied. This study aimed to investigate the diagnostic performance of CCTA combined with SYNTAX score II for selecting the revascularization method compared with invasive coronary angiography (ICA) based on 2014 European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) guidelines.

Methods

From January–May 2011, 160 patients who underwent both CCTA and ICA within 30 interval days were included. The diagnostic performance of CCTA, CCTA plus CT-SYNTAX score I and CT-SYNTAX score II was analysed using ICA counterparts as references.

Results

Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CCTA plus CT-SYNTAX I for selecting coronary artery bypass grafting (CABG) candidates using ICA plus ICA-SYNTAX I as reference, were 70.6 %, 95.8 %, 66.7 %, 96.5 % and 93.1 %, respectively. The diagnostic performance of CCTA plus CT-SYNTAX II showed improvement with values of 83.3 %, 97.3 %, 71.4 %, 98.6 % and 96.3 %, respectively, using ICA plus ICA-SYNTAX II as reference.

Conclusions

CCTA combined with CT-SYNTAX score II is an accurate method for selecting CABG surgery candidates compared with ICA-SYNTAX score II.

Key points

• SYNTAX plus CCTA can be highly specific for selecting the revascularization method.

• SYNTAX II was complemented by including clinical considerations to SYNTAX I.

• CCTA plus CT-SYNTAX II is an accurate method for selecting CABG candidates.

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Abbreviations

AUC:

Area under curve

CABG:

Coronary artery bypass grafting

CAD:

Coronary artery disease

CCTA:

Coronary computed tomography angiography

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

ECG:

Electrocardiograph

ESC/EACTS:

European Society of Cardiology/European Association for Cardio-Thoracic Surgery

GEE:

Generalized estimating equations

GFR:

Glomerular filtration rate

ICA:

Invasive coronary angiography

LM:

Left main

LR:

Likelihood

NPV:

Negative predictive value

PCI:

Percutaneous coronary intervention

PPV:

Positive predictive value

PVD:

Peripheral vascular disease

3VD:

Three-vessel disease

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Funding

This study was supported by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2010729).

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Authors and Affiliations

  1. Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Si Eun Lee, Kyunghwa Han, Jin Hur, Young Jin Kim, Hye-Jeong Lee, Yoo Jin Hong, Dong Jin Im & Byoung Wook Choi

Authors
  1. Si Eun Lee
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  2. Kyunghwa Han
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  3. Jin Hur
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  4. Young Jin Kim
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  5. Hye-Jeong Lee
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  7. Dong Jin Im
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Correspondence to Byoung Wook Choi.

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Guarantor

The scientific guarantor of this publication is Byoung Wook Choi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Lee, S.E., Han, K., Hur, J. et al. Accuracy of computed tomography for selecting the revascularization method based on SYNTAX score II. Eur Radiol 28, 2151–2158 (2018). https://doi.org/10.1007/s00330-017-5184-2

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  • DOI: https://doi.org/10.1007/s00330-017-5184-2

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