Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Objective: The Syntax score prognostic value has recently been highlighted in patients undergoing percutaneous coronary intervention (PCI) for multivessel coronary artery disease (CAD), however its prognostic value in patients undergoing coronary artery bypass grafting (CABG) for CAD is still unknown. The aim of our study, We applied the SYNTAX score in patients with coronary artery disease who underwent coronary artery bypass grafting to examine its role in predicting incidences of major adverse cardiac and cerebrovascular events (MACCE) within 30 days. Methods: retrospectively, 90 patients were included in this study and divided into subgroups according to the Syntax score as low ({u2264} 22), intermediate (> 22 and < 33) and high syntax ({u2265} 33) score. During the thrity day we follow- up cardiovascular events including death, myocardial infarction (MI), and stroke. Results: Overall SYNTAX score ranged from 10 to 67 (mean, 28.72 ± 10.19). At 30 days, 9 (10%) patients experienced MACCE which were one patient in low syntax sore (3.3%), four in intermediate syntax score (13.3%) and four in high syntax score (13.3%), then we analyzed our results into three parts. First part, comparison between different syntax score subgroups to elicit the ability of syntax score to predict early outcome but. No statistical difference was found for the composite criteria death/MI/stroke: 13.3% versus 13.3% in an intermediate and high Syntax score subgroups respectively (P= 0.269). Second part, determination of predictors in each syntax score subgroup that related to incidence of MACCE using univariate and multivariate analysis, except low Syntax score subgroup which could not be analyzed due to only one patient who had major adverse cardiac and cerebrovascular events (MACCE). the predictors of incidence of major cardiac and cerebrovascular events in different Syntax score subgroups, it were found the urgency of operation, incomplete revascularization and unstable angina presentation that were significantly predict 30-day MACCE in both intermediate and high Syntax score subgroups

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