European Journal of Cardiovascular Medicine

Background This study was conducted to evaluate the association of the syntax score with predicting short-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI).  Methods This was a hospital-based cross sectional observational study, conducted among 100 patients with left main or multi-vessel disease undergoing primary PCI and is validated to predict the outcomes of patients aged more than 18 years in the Department of Cardiology, Apollo Hospital, Bangalore Road, Bangalore, from July 2018 to June 2019, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.  Results Out of 100 patients on follow-up after one month, 83% improved symptomatically and were in NYHA functional class I, 8% in class II and < 5% in class III/IV. Follow-up echocardiography showed that all patients in the high syntax group had persistent RWMA. About 30% of the low-syntax group and 19% of the mid-syntax group showed no RWMA with a p-value of 0.185. However, there was no significant improvement in mean ejection fraction (EF) after PCI in all syntax groups with a p-value of 0.491. Five patients died within 30 days of the procedure (during 2nd- 3rd week after discharge) and 15 MACCE were recorded during this period. Out of which 4% each had ACS-NSTEMI and UA, 3% had ADHF, 1% each had CVA infarct and IC bleed, and 1% had stent thrombosis requiring revascularization with a p-value of < 0.001 which was statistically significant. Conclusion The syntax score has risk predictive value both in patients undergoing elective PCI and in those undergoing primary PCI for STEMI.