The association of the Syntax score II with carotid intima media thickness and epicardial fat tissue

Indian Heart J. Nov-Dec 2017;69(6):752-756. doi: 10.1016/j.ihj.2017.04.008. Epub 2017 Apr 18.


Aim: Syntax score II (SSII) is a highly predictive scoring system, which is used to improve individualized assessment of patients with complex coronary artery disease and facilitates clinical decision making. Surrogate markers [carotid intima-media thickness (CIMT), epicardial fat tissue (EFT)] are also used for risk assessment, but their relation with SSII is not well established.

Method: We enrolled 543 consecutive patients, who underwent coronary angiography for stable angina pectoris and acute coronary syndrome, in the study. SSII was calculated for each patient and the patients were divided into two groups as low SSII group and high SSII group according to their median SSII.

Results: The average age of the patients was 61.4 years and 75% of the patients were male. The multivariate analysis indicated that only EFT (p: 0,035), CIMT (p:0,04) and Hypertension (HT) (p: 0,014) were independently associated with high SSII.

Discussion: EFT and CIMT, the surrogate markers which can be simply and non-invasively determined, are of the independent predictors of high SSII. The inclusion of these parameters in the risk classification may provide additional clinical benefit.

Keywords: Carotid intima-media thickness; Coronary artery disease; Epicardial fat tissue; Syntax score.

MeSH terms

  • Adipose Tissue / diagnostic imaging*
  • Carotid Intima-Media Thickness*
  • Coronary Artery Disease / classification
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pericardium / diagnostic imaging*
  • Predictive Value of Tests
  • Risk Assessment*
  • Risk Factors
  • Severity of Illness Index
  • Turkey / epidemiology