The relationship between syntax score and blood pressure recovery ratio after exercise test in patients with coronary artery disease

Aim:We aimed to investigate the relationship between SYNTAX score, which shows the extent and complexity of coronary artery disease, and systolic blood pressure recovery ratio after exercise test. Methods: Of the 142 patients who underwent coronary angiography after exercise stress test,98 patients (79 males, 19 females; mean age 57,3 ± 7,3) who had at least > 50% occlusion in one coronary artery were includedin our study. Patients were divided into two group as thelow SYNTAX score group (SYNTAX score ≤ 22) and the intermediate-high SYNTAX score group(SYNTAX score > 23). All parameters were compared between these two groups. The systolic blood pressure recovery ratio was calculated by dividing the third minute systolic blood pressure by the peak exercise systolic blood pressure. Results: The SBP recovery ratio was 0.87 ± 0.06 in the low SS group, and 0.96 ± 0.05 in the intermediate-high SS group (p <0.001). Among the echocardiographic findings, EF, lateral e′, septal e′ and E/e ′ were significantly lower (p <0.05 for all), LVEDD, LA diameter and LA volume were significantly higher in the intermediate-high SS group (p <0.05 for all).In the correlation analysis, EF, laterale′ velocity, E/e ′, LA volume, SBP recovery ratiowere correlated with the SYNTAX score. In multivariate logistic regression analysis, we found SBP recovery ratio (OR: 1.446, p <0.001) and EF (OR: 0.802, p= 0.005) to be independent predictors of the intermediate-high SYNTAX score. The cut-off value of SBP recovery ratio obtained by ROC curve analysis was 0.928for prediction of intermediate-high SYNTAX score (sensitivity: 86.1%, specificity: 82.3%). The area under the curve (AUC) was 0.892 (p<0.001). Conclusion: We found a strong correlation between the SYNTAX score and the systolic blood pressure recovery ratio. The SBP recovery ratio, which can be xiv easily obtained during the exercise test, may increasethe predictive ability ofthe exercise test forprediction of the extent of coronary artery disease. Keywords: Stable coronary artery disease, Exercise test, SYNTAX score, Systolic blood pressure recovery ratio