Prediction of peri-procedural myocardial injury in patients undergoing percutaneous coronary intervention by syntax score

Percutaneous coronary intervention (PCI) is well established procedure for management of coronary artery disease. However, up to 50% of cases associated with myocardial injury with subsequent increased mortality. Currently there is no reliable method to predict this injury.Aim of the work: to investigate the ability of the syntax score to predict peri-procedure myocardial injury (PMI) in patients undergoing PCI. Patients and Methods: This study included 60 patients. They are divided into two groups (1 = Non-diabetics) and (2 = Diabetics) and subjected to: History and physical examination, ECG, echocardiography, calculation of syntax score, PCI and troponin T.Results: Our study shows highly significant elevation in the troponin level in both groups after PCI, this elevation was more in group (2) (<0.001). In all study population the incidence of PMI was low in patients with low syntax score and increased proportionally with the increase in syntax score. We found the syntax score cutoff value for prediction of PMI to be 15 with calculated sensitivity of 95.3%, specificity 88.2%, predictive value positive 95.3% and Predictive value negative 88.2%.Conclusion: Syntax score has the ability to predict the occurrence of PMI with accepted sensitivity. It can assess the patient risk for development of PMI which could help to rationalize the use of adjunctive therapies as distal embolic protection devices in high risk patients. Also, diabetic patients have higher incidence of complicated coronary lesions, higher syntax score and they are more labile for PMI