Collet Carlos, Onuma Yoshinobu, Miyazaki Yosuke, Morel Marie-Angèle, Serruys Patrick W
Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Cardialysis BV, Rotterdam, The Netherlands.
Cardiovasc Diagn Ther. 2017 Apr;7(2):151-158. doi: 10.21037/cdt.2017.03.19.
Since the early days of coronary angiography, the extension and severity of coronary artery disease (CAD) have been used for risk stratification. The SYNTAX score objectively characterizes CAD in patients with multivessel disease. Furthermore, recalculating the SYNTAX score by the incorporation of the functional component coronary stenosis (i.e., FFR) increases the discrimination for the risk of adverse events. The calculation of the SYNTAX score derived from non-invasive modalities such as coronary computed tomography angiography (CTA) has emerged as a mean to obtain the SYNTAX score before invasive cardiac catheterization. Likewise, the computation of the non-invasive fractional flow reserve CT (FFR) allows for the calculation of the non-invasive functional SYNTAX score. Ultimately, the combination of anatomical and functional evaluations with clinical factors further refines the identification of patients at risk and provides a recommendation for the Heart Team regarding the treatment strategy (i.e., PCI or CABG) based on the predicted 4-year mortality. The purpose of this review is to describe the integration of a novel non-invasive functional coronary assessment with the angiographic risk score in patients with multivessel CAD.
自冠状动脉造影早期以来，冠状动脉疾病（CAD）的范围和严重程度一直用于风险分层。SYNTAX评分客观地描述了多支血管病变患者的CAD情况。此外，通过纳入功能性冠状动脉狭窄（即FFR）重新计算SYNTAX评分，可提高对不良事件风险的辨别能力。源自冠状动脉计算机断层扫描血管造影（CTA）等非侵入性检查方法的SYNTAX评分计算方法已成为在进行侵入性心脏导管插入术前获取SYNTAX评分的一种手段。同样，非侵入性血流储备分数CT（FFR）的计算也能得出非侵入性功能SYNTAX评分。最终，将解剖学和功能评估与临床因素相结合，可进一步优化对高危患者的识别，并根据预测的4年死亡率为心脏团队提供有关治疗策略（即PCI或CABG）的建议。本综述的目的是描述在多支血管CAD患者中，将新型非侵入性功能冠状动脉评估与血管造影风险评分相结合的情况。
