Garg et al developed the Clinical SYNTAX Score (CSS) to improve risk stratification of patients with complex coronary artery disease. The authors are members of the ARTS-II investigators.
Patient selection: patient undergoing a percutaneous coronary intervention (PCI)
Outcome: major adverse cardiovascular events (MACCE = death, stroke, revascularization procedure and/or myocardial infarction)
Parameters:
(1) Syntax score (see below)
(2) age in years
(3) creatinine clearance by the Cockcroft-Gault equation prior to index PCI
(4) left ventricular ejection fraction in percent prior to index PCI (minimum if several values available)
Creatinine Clearance in mL per min per square meter
Points
>= 60
0
50 to 59
1
40 to 49
2
30 to 39
3
20 to 29
4
10 to 19
5
< 10
6
modified ACEF score =
= ((age) / (percent LVEF as decimal)) + (points for creatinine clearance)
NOTE: ACEF model of Ranucci et al discussed in 06.04.33
clinical Syntax score =
= (Syntax score) * (modified ACEF score)
Clinical Syntax Score
Tertile
<= 15.6
low
15.61 to 27.5
middle
> 27.5
high
Performance:
• The area under the ROC curve was 0.69 for 5-year mortality and 0.62 for 5-year MACCE.
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