Paradigm Has Already Shifted to Ischemia-Guided Functional Approach
The anatomical SYNTAX (Synergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery) score is a stratification score illustrating the complexity of angiographic stenosis. It was considered a surrogate for poor prognosis following percutaneous coronary intervention (PCI).1 Accordingly, in patients with a high baseline SYNTAX score (bSS) requiring coronary revascularization, coronary artery bypass graft (CABG) surgery was chosen over PCI in the current guidelines.2, 3 The mechanism by which bSS is a good surrogate for long-term prognosis is evident. Patients with a high bSS compared to those with a low bSS have more complex comorbidities, such as old age, diabetes, multiple stenoses, and low left ventricular function. Subsequently, they receive more complex procedures using multiple stents and devices. Since revising the SYNTAX score II by taking into consideration clinical risk factors, the function of the scoring model in choosing between PCI and CABG and prognosis prediction has improved.4
- Received June 7, 2013.
- Accepted June 10, 2013.