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Chirurgia 2016 April;29(2):31-3

lingua: Inglese

Gender difference in Syntax Score: implications for risk scoring and outcomes

Konstantinos KOTIDIS, Delia MARINCEU, Mahmoud LOUBANI

Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK


BACKGROUND: Female gender represents a negative prognostic factor following coronary artery bypass surgery (CABG) specifically and cardiac surgery in general compared with male patients. This fact is well documented in the current risk stratification systems. Through this study we explore gender difference in the complexity of coronary anatomy between male and female patients.
METHODS: One hundred male and one hundred female consecutive patients who underwent elective coronary artery bypass surgery over a 2-year period in our department were included in the study. A blinded observer calculated the anatomical syntax score data for all the patients.
RESULTS: The two groups of patients were similar in age (66.8±9.0 vs. 68.1±8.7; P=0.31) and Logistic Euroscore (3.3±2.7 vs. 4.0±2.9; P=0.06). The female patients had a significantly higher anatomical Syntax score (39.6±13.7 vs. 32.8±9.8; P=0.0002), mean number of lesions (4.3±1.5 vs. 3.6±1.2; P=0.0019), mean number of bifurcated lesions (0.5±0.6 vs. 0.2±0.3; P=0.0002) and mean number of trifurcated lesions (0 versus 0.03±0.17; P=0.04).
CONCLUSIONS: There is higher complexity of coronary anatomy in females compared to males. This may explain the difference in predicted mortality following cardiac surgery. We propose that the anatomical Syntax score could potentially be included in the risk stratification scoring systems, for patients undergoing CABG.

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