Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease

Shigetaka Kageyama; Patrick W Serruys; Nozomi Kotoku; Scot Garg; Kai Ninomiya; Shinichiro Masuda; Marie-Angele Morel; Charles A Taylor; Campbell Rogers; Brian Thomsen; Gianluca Pontone; Giulio Pompilio; John D Puskas; Torsten Doenst; Mark La Meir; Ulf Teichgräber; Himanshu Gupta; Johan De Mey; Daniele Andreini; Yoshinobu Onuma

doi:10.1016/j.jcct.2023.10.012

Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease

Shigetaka Kageyama, Patrick W Serruys, Nozomi Kotoku, Scot Garg, Kai Ninomiya, Shinichiro Masuda, Marie-Angele Morel, Charles A Taylor, Campbell Rogers, Brian Thomsen, Gianluca Pontone, Giulio Pompilio, John D Puskas, Torsten Doenst, Mark La Meir, Ulf Teichgräber, Himanshu Gupta, Johan De Mey, Daniele Andreini, Yoshinobu Onuma

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

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Abstract

BACKGROUND: Since the initial attempt to adapt the anatomical SYNTAX score (aSS) to coronary computed tomography angiography (CCTA), CCTA imaging technology has evolved, and is currently used as a "decision-maker" for revascularization strategy in complex coronary artery disease (CAD) and has rendered necessary some updating of the aSS to the CCTA modality.

OBJECTIVES: The aim is to provide updated definitions of the aSS derived from CCTA in patients with complex CAD undergoing CABG.

METHODS: The modifications of CCTA-aSS are the following; (i) updated definition and detection criteria of total occlusion (TO) in CCTA based on length assessment, (ii) inclusion of scoring points for serial bifurcations located in one single coronary segment. (iii) inclusion of weighing score points for lesions located distal to a TO, not visualized on conventional coronary angiography, but visible in CCTA, (iv) removal of thrombus and bridging collateral items from the weighing score, considering the limited diagnostic capability of CCTA in detecting these specific lesion characteristics.

RESULTS: the updated CCTA-aSS was tested in a first-in-man study using the sole guidance of CCTA for the planning and performance of bypass surgery in complex CAD (n = 114). An interobserver analysis showed excellent reproducibility (ICC = 0.96, 95 % confidence interval 0.94-0.97).

CONCLUSION: The updated CCTA-aSS was implemented in a cohort of patients with complex CAD undergoing CABG with the sole guidance of CCTA and FFRCT and the Inter-reproducibility of the analysis of the updated score was found excellent. The prognostic value of the modified CCTA-aSS will be examined in future studies.

Original language	English
Pages (from-to)	120-136
Number of pages	17
Journal	Journal of cardiovascular computed tomography
Volume	18
Issue number	2
Early online date	26 Oct 2023
DOIs	https://doi.org/10.1016/j.jcct.2023.10.012
Publication status	Published - 1 Mar 2024

Bibliographical note

Keywords

Anatomic SYNTAX score
Complex coronary artery disease
Coronary artery bypass graft
Revascularization

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Kageyama, S., Serruys, P. W., Kotoku, N., Garg, S., Ninomiya, K., Masuda, S., Morel, M-A., Taylor, C. A., Rogers, C., Thomsen, B., Pontone, G., Pompilio, G., Puskas, J. D., Doenst, T., La Meir, M., Teichgräber, U., Gupta, H., De Mey, J., Andreini, D., & Onuma, Y. (2024). Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease. Journal of cardiovascular computed tomography, 18(2), 120-136. https://doi.org/10.1016/j.jcct.2023.10.012

Kageyama, Shigetaka ; Serruys, Patrick W ; Kotoku, Nozomi ; Garg, Scot ; Ninomiya, Kai ; Masuda, Shinichiro ; Morel, Marie-Angele ; Taylor, Charles A ; Rogers, Campbell ; Thomsen, Brian ; Pontone, Gianluca ; Pompilio, Giulio ; Puskas, John D ; Doenst, Torsten ; La Meir, Mark ; Teichgräber, Ulf ; Gupta, Himanshu ; De Mey, Johan ; Andreini, Daniele ; Onuma, Yoshinobu. / Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease. In: Journal of cardiovascular computed tomography. 2024 ; Vol. 18, No. 2. pp. 120-136.

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abstract = "BACKGROUND: Since the initial attempt to adapt the anatomical SYNTAX score (aSS) to coronary computed tomography angiography (CCTA), CCTA imaging technology has evolved, and is currently used as a {"}decision-maker{"} for revascularization strategy in complex coronary artery disease (CAD) and has rendered necessary some updating of the aSS to the CCTA modality.OBJECTIVES: The aim is to provide updated definitions of the aSS derived from CCTA in patients with complex CAD undergoing CABG.METHODS: The modifications of CCTA-aSS are the following; (i) updated definition and detection criteria of total occlusion (TO) in CCTA based on length assessment, (ii) inclusion of scoring points for serial bifurcations located in one single coronary segment. (iii) inclusion of weighing score points for lesions located distal to a TO, not visualized on conventional coronary angiography, but visible in CCTA, (iv) removal of thrombus and bridging collateral items from the weighing score, considering the limited diagnostic capability of CCTA in detecting these specific lesion characteristics.RESULTS: the updated CCTA-aSS was tested in a first-in-man study using the sole guidance of CCTA for the planning and performance of bypass surgery in complex CAD (n = 114). An interobserver analysis showed excellent reproducibility (ICC = 0.96, 95 % confidence interval 0.94-0.97).CONCLUSION: The updated CCTA-aSS was implemented in a cohort of patients with complex CAD undergoing CABG with the sole guidance of CCTA and FFRCT and the Inter-reproducibility of the analysis of the updated score was found excellent. The prognostic value of the modified CCTA-aSS will be examined in future studies.",

keywords = "Anatomic SYNTAX score, Complex coronary artery disease, Coronary artery bypass graft, Revascularization",

author = "Shigetaka Kageyama and Serruys, {Patrick W} and Nozomi Kotoku and Scot Garg and Kai Ninomiya and Shinichiro Masuda and Marie-Angele Morel and Taylor, {Charles A} and Campbell Rogers and Brian Thomsen and Gianluca Pontone and Giulio Pompilio and Puskas, {John D} and Torsten Doenst and {La Meir}, Mark and Ulf Teichgr{\"a}ber and Himanshu Gupta and {De Mey}, Johan and Daniele Andreini and Yoshinobu Onuma",

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Kageyama, S, Serruys, PW, Kotoku, N, Garg, S, Ninomiya, K, Masuda, S, Morel, M-A, Taylor, CA, Rogers, C, Thomsen, B, Pontone, G, Pompilio, G, Puskas, JD, Doenst, T, La Meir, M, Teichgräber, U, Gupta, H, De Mey, J, Andreini, D & Onuma, Y 2024, 'Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease', Journal of cardiovascular computed tomography, vol. 18, no. 2, pp. 120-136. https://doi.org/10.1016/j.jcct.2023.10.012

Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease. / Kageyama, Shigetaka; Serruys, Patrick W; Kotoku, Nozomi; Garg, Scot; Ninomiya, Kai; Masuda, Shinichiro; Morel, Marie-Angele; Taylor, Charles A; Rogers, Campbell; Thomsen, Brian; Pontone, Gianluca; Pompilio, Giulio; Puskas, John D; Doenst, Torsten; La Meir, Mark; Teichgräber, Ulf; Gupta, Himanshu; De Mey, Johan; Andreini, Daniele; Onuma, Yoshinobu.

In: Journal of cardiovascular computed tomography, Vol. 18, No. 2, 01.03.2024, p. 120-136.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease

AU - Kageyama, Shigetaka

AU - Serruys, Patrick W

AU - Kotoku, Nozomi

AU - Garg, Scot

AU - Ninomiya, Kai

AU - Masuda, Shinichiro

AU - Morel, Marie-Angele

AU - Taylor, Charles A

AU - Rogers, Campbell

AU - Thomsen, Brian

AU - Pontone, Gianluca

AU - Pompilio, Giulio

AU - Puskas, John D

AU - Doenst, Torsten

AU - La Meir, Mark

AU - Teichgräber, Ulf

AU - Gupta, Himanshu

AU - De Mey, Johan

AU - Andreini, Daniele

AU - Onuma, Yoshinobu

PY - 2024/3/1

Y1 - 2024/3/1

N2 - BACKGROUND: Since the initial attempt to adapt the anatomical SYNTAX score (aSS) to coronary computed tomography angiography (CCTA), CCTA imaging technology has evolved, and is currently used as a "decision-maker" for revascularization strategy in complex coronary artery disease (CAD) and has rendered necessary some updating of the aSS to the CCTA modality.OBJECTIVES: The aim is to provide updated definitions of the aSS derived from CCTA in patients with complex CAD undergoing CABG.METHODS: The modifications of CCTA-aSS are the following; (i) updated definition and detection criteria of total occlusion (TO) in CCTA based on length assessment, (ii) inclusion of scoring points for serial bifurcations located in one single coronary segment. (iii) inclusion of weighing score points for lesions located distal to a TO, not visualized on conventional coronary angiography, but visible in CCTA, (iv) removal of thrombus and bridging collateral items from the weighing score, considering the limited diagnostic capability of CCTA in detecting these specific lesion characteristics.RESULTS: the updated CCTA-aSS was tested in a first-in-man study using the sole guidance of CCTA for the planning and performance of bypass surgery in complex CAD (n = 114). An interobserver analysis showed excellent reproducibility (ICC = 0.96, 95 % confidence interval 0.94-0.97).CONCLUSION: The updated CCTA-aSS was implemented in a cohort of patients with complex CAD undergoing CABG with the sole guidance of CCTA and FFRCT and the Inter-reproducibility of the analysis of the updated score was found excellent. The prognostic value of the modified CCTA-aSS will be examined in future studies.

AB - BACKGROUND: Since the initial attempt to adapt the anatomical SYNTAX score (aSS) to coronary computed tomography angiography (CCTA), CCTA imaging technology has evolved, and is currently used as a "decision-maker" for revascularization strategy in complex coronary artery disease (CAD) and has rendered necessary some updating of the aSS to the CCTA modality.OBJECTIVES: The aim is to provide updated definitions of the aSS derived from CCTA in patients with complex CAD undergoing CABG.METHODS: The modifications of CCTA-aSS are the following; (i) updated definition and detection criteria of total occlusion (TO) in CCTA based on length assessment, (ii) inclusion of scoring points for serial bifurcations located in one single coronary segment. (iii) inclusion of weighing score points for lesions located distal to a TO, not visualized on conventional coronary angiography, but visible in CCTA, (iv) removal of thrombus and bridging collateral items from the weighing score, considering the limited diagnostic capability of CCTA in detecting these specific lesion characteristics.RESULTS: the updated CCTA-aSS was tested in a first-in-man study using the sole guidance of CCTA for the planning and performance of bypass surgery in complex CAD (n = 114). An interobserver analysis showed excellent reproducibility (ICC = 0.96, 95 % confidence interval 0.94-0.97).CONCLUSION: The updated CCTA-aSS was implemented in a cohort of patients with complex CAD undergoing CABG with the sole guidance of CCTA and FFRCT and the Inter-reproducibility of the analysis of the updated score was found excellent. The prognostic value of the modified CCTA-aSS will be examined in future studies.

KW - Anatomic SYNTAX score

KW - Complex coronary artery disease

KW - Coronary artery bypass graft

KW - Revascularization

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U2 - 10.1016/j.jcct.2023.10.012

DO - 10.1016/j.jcct.2023.10.012

M3 - Article

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VL - 18

SP - 120

EP - 136

JO - JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY

JF - JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY

SN - 1934-5925

IS - 2

ER -

Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease

Abstract

Bibliographical note

Keywords

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