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Prognostic significance of the residual SYNTAX score after coronary stenting

Authors: Keren M.A., Sigaev I.Yu, Zakrevsky E.L., Yakhyaeva K.B., Odisharia N.T., Musaev M.K., Zavalikhina T.V., Klyuchnikov I.V., Volkovskaya I.V., Avakova S.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2026-20-2-257-266

For citation: Keren M.A., Sigaev I.Yu, Zakrevsky E.L., Yakhyaeva K.B., Odisharia N.T., Musaev M.K., Zavalikhina T.V., Klyuchnikov I.V., Volkovskaya I.V., Avakova S.A. Prognostic significance of residual SYNTAX score after coronary stenting. Creative Cardiology. 2026; 20 (2): 257–266 (in Russ.). DOI: 10.24022/1997-3187-2026-20-2-257-266

Received / Accepted:  10.03.2026 / 08.05.2026

Keywords: coronary artery disease percutaneous coronary stenting SYNTAX score multivessel coronary artery disease



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Abstract

Aim. To assess the prognostic significance of the residual SYNTAX score in patients with coronary artery disease (CAD) and multivessel disease following percutaneous coronary intervention (PCI).

Material and Methods. This retrospective study included 197 patients with CAD and multivessel coronary artery (CA) disease who underwent elective PCI. The baseline SYNTAX score, residual SYNTAX score, and the mean change in score before and after PCI (Δ SYNTAX) were calculated for all patients. The mean follow-up period was 76.7 (73.9–79.5) months. The study endpoints were all-cause death (from any cause) and cardiovascular death occurring during the follow- up period of up to 7 years after the intervention.

Results. In patients with CAD referred for elective PCI, there is a strong positive correlation (ρ=0.756, p<0.001) between baseline and residual SYNTAX scores. A high residual SYNTAX score is associated with high comorbidity burden and increased anatomical procedural risks due to a high incidence of three-vessel CA disease combined with left main coronary artery (LMCA) disease, as well as CA occlusion. A residual SYNTAX score >10 after PCI is associated with an increased risk of all-cause (OR 2.595 (95% CI 1.258–5.355), p=0.010) and cardiovascular mortality (OR 3.792 (95% CI 1.267– 1.352), p=0.017). Groups with residual SYNTAX scores of 0–5 and 6–10 showed no statistically significant differences in long-term survival.

Conclusion. A residual SYNTAX score >10 is associated with an increased risk of all-cause (OR 2.595 (95% CI 1.258– 5.355), p=0.010) and cardiovascular mortality (OR 3.792 (95% CI 1.267–1.352), p=0.017). A residual SYNTAX 0 to 10 after PCI is associated with a low risk profile for long-term mortality.

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About Authors

  • Milena A. Keren, Рrofessor; ORCID
  • Igor Yu. Sigaev, Dr. Med. Sci., Professor, Head of the Department of Surgery for Combined Diseases of the Coronary and Major Arteries, Director of the Institute of Coronary and Vascular Surgery; ORCID
  • Efim L. Zakrevsky, Postgraduate, Cardiologist; ORCID
  • Kumushdzhan B. Yakhyaeva, Junior Researcher, Cardiologist; ORCID
  • Naum T. Odisharia, Cand. Med. Sci., Endovascular Surgeon; ORCID
  • Magomedrasul K. Musaev, Cand. Med. Sci., Acting Head of Department, Endovascular Surgeon; ORCID
  • Tatyana V. Zavalikhina, Cand. Med. Sci., Chief Physician of the Institute of Coronary and Vascular Surgery; ORCID
  • Ivan V. Klyuchnikov, Dr. Med. Sci., Professor, Chief Researcher, Cardiologist; ORCID
  • Irina V. Volkovskaya, Cand. Med. Sci., Head of Department; ORCID
  • Susanna A. Avakova, Cand. Med. Sci., Head of Department; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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