The Impact of SYNTAX Score with Longterm Outcomes of Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention for Left Main Coronary Artery Disease: A Systematic Review

Abstract

The SYNTAX  score was designed to predict the postprocedural risk associated with PCI or surgical revascularization. This study aims to evaluate long term (>5 years) outcome of PCI with CABG by comparing several existing studies. A systematic search was conducted through PubMed/MEDLINE and ScienceDirect databases. This systematic review used all studies in the field of differences in outcome of PCI and CABG intervention in left main coronary artery stenosis. This study used cross sectional study design with a systematic review method based on several cohort studies. The search was conducted until February 10th, 2023. Assessment of the study quality was carried out using the criteria of the Newcastle-Ottawa Scale (NOS). Based on the final assessment, all included studies had a mean NOS score of 8 which could be interpreted as excellent quality. Our search yielded 1675 studies of which we included 5 studies for the final analysis. A total of 5.494 patients were treated with PCI and CABG. In this study, there were differences outcome in low, medium and high syntax scores on long term major adverse cardiac or cerebrovascular events (MACCE) and long term mortality. However, the similar outcome was obtained in long term revascularization, long term stroke and long term Miokard Infark (MI). Left main coronary artery (LMCA) stenosis patients with low to high SS may result various long-term outcomes. CABG is associated with lower incidence of mortality, repeat revascularization, myocardial infarction, and MACCE than PCI. Meanwhile, PCI gives lower incidence of stroke.