The impact of preoperative syntax score on mortality and morbidity following surgical revascularization: Early and mid-term outcomes

Aim: The aim of this study was to evaluate the prognostic value of the preoperative SYNTAX score in predicting early- and mid-term major adverse cardiovascular and cerebrovascular events (MACCE) in patients undergoing coronary artery bypass grafting (CABG) surgery. Material and Methods: The data of 327 patients who underwent elective CABG at Bezmialem Vakif University between 2019 and 2023 were retrospectively analyzed. Patients were categorized into low-risk (≤22) and intermediate-to-high-risk (≥23) groups according to the SYNTAX score. Demographic characteristics, comorbidities, laboratory and echocardiographic parameters, surgical features, in-hospital outcomes, and overall complication rates during follow-up were compared between the groups. Results: There were no significant differences between the groups in terms of age, sex, or comorbidities. Left main coronary artery (LMCA) disease combined with multivessel involvement was more frequently observed in the intermediate-to-high SYNTAX group. Left ventricular ejection fraction was significantly lower in this group (p=0.044). Although individual complication rates were numerically higher in the intermediate-to- high SYNTAX group during follow-up, the differences were not statistically significant (p>0.05). However, the incidence of MACCE was significantly greater in the intermediate-to-high SYNTAX group compared with the low SYNTAX group (25.8% vs. 14.2%; p=0.017). Conclusion: The preoperative SYNTAX score provides an independent and complementary prognostic value in predicting composite cardiovascular outcomes after CABG surgery, beyond conventional clinical risk scales. Keywords: Coronary artery disease, SYNTAX score, Coronary artery bypass grafting, Mortality, Major adverse cardiovascular and cerebrovascular events