SYNTAX Score and Outcomes of Coronary Revascularization in Diabetic Patients

  • Amartya Kundu
  • Partha Sardar
  • Kevin O’Day
  • Saurav Chatterjee
  • Theophilus Owan
  • J. Dawn Abbott
Ischemic Heart Disease (D Mukherjee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Ischemic Heart Disease


Purpose of Review

This review describes the dynamic relationship between diabetes mellitus (DM) and coronary artery disease (CAD) with respect to different revascularization strategies and how angiographic tools such as the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score can supplement clinical decision-making.

Recent Findings

The SYNTAX score characterizes the anatomical extent of CAD in terms of the number of lesions, functional importance, and complexity. Studies not limited to patients with DM suggest that percutaneous coronary intervention (PCI) is a reasonable alternative to coronary artery bypass grafting (CABG) in patients with low-medium SYNTAX scores, while patients with high SYNTAX scores should be revascularized with CABG if operable. Similar findings were also observed for diabetes patients with multivessel disease in retrospective pooled analysis. The SYNTAX II score combines anatomical and clinical risk to improve upon the decision regarding the optimal revascularization strategy. The SYNTAX II score can be applied to patients with DM.


The SYNTAX scores provide guidance to clinicians faced with determining the optimal revascularization strategy in patients with DM and advanced CAD. Using a heart team approach, the information can be considered along with other factors that influence PCI or CABG risk.




Compliance with Ethical Standards

Conflict of Interest

Amartya Kundu, Partha Sardar, Kevin O’Day, Saurav Chatterjee, and Theophilus Owan declare that they have no conflict of interest.

Dr. J. Dawn Abbott reports clinical trial consulting for Pfizer (antihyperlipidemic therapy) and Recor (renal denervation).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Amartya Kundu
    • 1
  • Partha Sardar
    • 2
  • Kevin O’Day
    • 3
  • Saurav Chatterjee
    • 4
  • Theophilus Owan
    • 2
  • J. Dawn Abbott
    • 5
  1. 1.Department of Cardiovascular MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Division of Cardiovascular MedicineUniversity of Utah Health Science CenterSalt Lake CityUSA
  3. 3.Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Department of Cardiology, Saint Francis Hospital, Teaching AffiliateUniversity of Connecticut School of MedicineHartfordUSA
  5. 5.Division of Cardiology, Brown Medical SchoolRhode Island HospitalProvidenceUSA

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