NON INVASIVE TESTS AND THE SYNTAX SCORE IN EVALUATING CORONARY ARTERY DISEASE, IS THERE A LINK ?

Abstract

Background: Coronary artery disease is one of the main causes of
cardiovascular morbidity and mortality all-around the world, the cost of
invasive and non invasive methods for diagnosing and assessing its
severity are increasing. Efforts are done to decrease costs needed by
every patient for enough evaluation of his condition and state.
Aim of the work: Studying the relationship between Duke treadmill
score and SYNTAX score
Subjects and methods:This study incorporated 40 patients presenting
with stable angina and typical chest pain. Resting and exercise ECG
were done to them and duke treadmill score was calculated to those with
positive exercise ECG. At last coronary angiography was done, the
SYNTAX score was calculated in every patient.
Results :A strong negative relationship between the duke score and the
SYNTAX score was present, also there was a significant positive
relation between the presence of diabetes, cigarette smoking,
dyslipidemia, positive family history of ischemic heart disease and the
SYNTAX score, there was an inverse relation between BMI and the
SYNTAX score. And also there was a positive relation between
presence of LAD lesions , presence of bifurcation lesions and increasing
the duke score risk.
Conclusion :There is a strong relationship between duke treadmill score
and the SYNTAX score. Thus patients with low risk according to the
duke score have no necessity to perform coronary angiography, only
medical treatment and follow up is enough. Patients with high duke
score risk must perform coronary angiography as this group is expected
to have complex coronary lesions and need invasive intervention, while
patients with intermediate duke score risk must be further evaluated by
assessing the presence of risk factors or using imaging modality to risk
stratify this group.