Comparison of coronary risk scoring systems to predict the severity of coronary artery disease using the SYNTAX score

Abstract

Background: Reliable risk scoring systems that can predict the severity of coronary artery disease (CAD) are necessary to implement effective management strategies in high-risk patients. Atherosclerotic vascular disease and with cardiovascular morbidity and mortality risk are patients who would benefit most from a change in patients at high risk factors. Framingham Risk Score, the Prospective Cardiovascular Münster (PROCAM) score and Systematic Coronary Risk Evaluation (SCORE) risk scores are used for this purpose. The severity of the CAD as detected by coronary angiography can be estimated using the SYNTAX score. In this study, it is aimed to assess the relation between SYNTAX score and the Framingham, PROCAM and SCORE scores in the context of their utility for the determination of the severity of the CAD.

Methods: A total of 205 patients with documented CAD who underwent coronary angiography due to a diagnosis of stable angina pectoris were included in this study. Coronary risk scores were determined for each patient. The relation between the SYNTAX score and the results of coronary risk scoring systems were analyzed.

Results: A positive relationship between the SYNTAX score, which reflects the severity of the CAD and coronary risk scores was found. However, Framingham and SCORE were superior, i.e., had more predictive value, regarding their ability to predict the SYNTAX score (p = 0.029, 0.033 and 0.002, respectively).

Conclusions: Examination of the distribution of SYNTAX score across low, intermediate and high-risk groups showed a significantly higher predictive value of SCORE for high-risk patients (p = 0.005).