SYNTAX Score II predicts carotid disease in a multivessel coronary disease population

Background: The SYNTAX Score (SxScore) is an angiographic tool that evaluates CAD complexity, which wepreviously reported lacking correlation with the presence of carotid disease. Recently, SxScore II has beendeveloped including both angiographic and clinical variables, which could increase the prognostic accuracy fordetection of carotid disease.Methods and results: From January 2013 to June 2014, 244 patients with multivessel CAD (mean age 65.37 years,84% males) underwent carotid ultrasound scan. At least one carotid lesion (CL) was found in 77% of patientswithsignificant carotid disease (SCD) in 23.4% of cases. Logistic regression analysis revealed no relation betweenSxScore and CL/SCD (p = 0.781 and p = 0.368) while SxScore II well correlated with CL (SxScore II-PCI: oddsratio [OR] 1.036; 95% confidence interval [CI]:1.006–1.067; p = 0.019; SxScore II-CABG: OR 1.045; 95% CI:1.015–1.076, p = 0.003) and SCD (SxScore II-PCI: OR 1.042; 95% CI: 1.012–1.073, p = 0.006; SxScore-CABG:OR 1.054; 95% CI: 1.029–1.080, p b 0.0001). The areas under the receiver-operating characteristic curves were:for SxScore 0.512 (95% CI: 0.448–0.577; p = 0.77), for SxScore II-PCI and SxScore II-CABG 0.600 (95% CI:0.536–0.662; p = 0.01) and 0.645 (95% CI: 0.581–0.705; p = 0.0008), respectively, and 0.527 (95% CI 0.462–0.591; p=0.56), 0.619 (95% CI: 0.555–0.681; p=0.01) and 0.681 (95% CI: 0.619–0.739; p=0.0001), respectively,for the identification of SCD.Conclusions: The SxScore II, with inclusion of clinical variables over angiographic complexity, seems more suitedto predict the presence of carotid disease than the SxScore.