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Syntax score—A predictor of coronary collateral status

Anish Singhal, Sheila Pai, Padmanabh Kamath, Rekha Kini, Mukund P S, Chakrapani Mahabala.


Background: Diabetes increases the oxidative stress over the myocardium that leads to arteriogenesis. Coronary collaterals (CC) serve as an alternative source of blood supply to the compromised myocardium. Though a few insights about the development and associations of CC in coronary artery disease (CAD) are known, conclusive data regarding their predictors is still a matter of active research. Around 25 parameters are found to be predicting well-developed CC, but their clinical usability is not established.

Aims and Objective: This study was designed to find the association of predictors of CC in type 2 diabetes mellitus patients on conservative management for CAD.

Materials and Methods: This was a cross-sectional study done after the institutional ethics committee approval. Forty-one patients from a tertiary care hospital in Mangalore, of either sex, were selected based on inclusion and exclusion criteria. Diagnosis of diabetes was according to American Diabetes Association guidelines. Body mass index, total cholesterol, low-density lipoprotein, history of smoking, and duration of diabetes were also measured. Angiographic grading of CC by Rentrop’s grading and calculation of severity of CAD by syntax score was done in the presence of a cardiologist. The data were analyzed using logistic regression analysis, p value < 0.05 was considered significant.

Results: Results portrayed that syntax score >22 (p = 0.008) was significantly associated with the development of CC.

Conclusion: Severity of CAD, as indicated by syntax score, can independently predict the development of CC in diabetics on conservative management for CAD.

Key words: Diabetes, Coronary Collaterals, Predictors, Coronary Artery Disease, Conservative Management, Syntax Score

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