Angina Clinical Trial
Official title:
A Retrospective Analysis Determining the Impact of Coronary Anatomy on Angina Relief in Patients Undergoing Coronary
We hypothesize that Coronary Artery Disease (CAD) severity assessed by SYNTAX score is an independent predictor of recurrent or persistent angina following coronary revascularization. The SYNTAX score is a score that suggests the severity of coronary artery disease detected by coronary angiography. Coronary revascularization is a procedure that occurs in two ways, a percutaneous coronary intervention (PCI) and a coronary artery bypass graft (CABG) and is done when there is narrowing and blockage or hardening of the arteries (atherosclerosis) surrounding the heart. Narrowing and blockages reduce blood flow to parts of the heart causing chest pain (known as angina) and sometimes myocardial infarction.
PCI and CABG are two well-established revascularization approaches to treatment of chronic
angina caused by coronary atherosclerosis. Nevertheless, 35-42% of patients report recurring
or persisting anginal symptoms after coronary revascularization. This can be attributed to
many structural and functional causes, prominent amongst which is pre-revascularization
angina severity, unrevascularized coronary territory, progression of native or bypass graft
atherosclerosis, restenosis (re-narrowing of the vessels) and accompanying adjunctive
pharmacotherapy.
The SYNTAX score is an angiographic tool for grading the complexity of coronary disease. It
is the sum of points assigned to coronary lesions within one of the 16 segments of the
coronary tree. The segments are given a 1,2, or 5 based on the disease presence as defined
by the American Heart Association classification. The SYNTAX score has been used to help
predict the outcomes of patients undergoing PCI with 3-vessel involvement (e.g. a triple
bypass or 3-stent placement PCI). Those patients with the highest scores had the highest
risk of a poor outcome with PCI revascularization compared to CABG. Despite these
observations, the impact of CAD severity on post-revascularization angina, using the SYNTAX
has never been systematically addressed in the current era.
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Time Perspective: Retrospective
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