Comparative Analysis of SYNTAX and BCIS Jeopardy Score of Diabetics Versus Non-Diabetic Patients with Complex Coronary Artery Disease.

Diabetic patients tend to have complex coronary artery disease (CAD). Understanding their procedural risk may help to guide treatment strategies. SYNTAX and the British Cardiovascular Intervention Society Jeopardy Score (BCIS-JS) have been used to define complex CAD, but their use has not been compared in diabetic patients. This is a retrospective analysis of prospectively collected data of consecutive patients who underwent complex percutaneous coronary intervention (PCI) and were deemed unsuitable for surgical revascularization. Both SYNTAX and BCIS-JS were calculated by experienced operators who were blinded to patient's outcome. The primary endpoint was all-cause mortality at 12 months. Of 452 patients included in the study, diabetes was present in 35% patients. There was a modest relationship between BCIS-JS and SYNTAX score (Spearman r = 0.44, < 0.001) and this relationship was even weaker in patients with diabetes (Spearman r = 0.32, < 0.001). The primary endpoint was comparable in the non-diabetic group, irrespective of the score system (SYNTAX or BCIS-JS) used to define complex CAD. In contrast, there was a differential prognostic outcome in the diabetic group, whereby the primary endpoint was more frequently reported in diabetic patients with high versus low SYNTAX scores [HR 4.96, 95% CI (1.44-17.03), = 0.011] but not when BCIS-JS was used. There was a modest relationship between BCIS-JS and SYNTAX score. Unlike BCIS-JS, the SYNTAX score identified those who are at increased risk of death among diabetic patients. Both scoring systems did not effectively differentiate mortality risk in non-diabetic patients. Future research is needed to confirm this study's findings.