SYNTAX Score for Coronary Artery Disease
Anatomical scoring system grading complexity of coronary artery disease on angiography. Guides decision between PCI and CABG in multivessel or left main disease.
Score interpretation
→ SYNTAX Low (0–22): Low anatomical complexity. PCI is preferred over CABG in most guidelines (ESC/EACTS). Similar outcomes to CABG at 5 years in low SYNTAX. Proceed with PCI using second-generation DES.
→ SYNTAX Intermediate (23–32): Intermediate complexity. Heart team discussion mandatory (cardiologist + cardiac surgeon + patient). Either PCI or CABG acceptable; CABG may be preferred in diabetics with multivessel disease (FREEDOM trial).
→ SYNTAX High (≥33): High anatomical complexity. CABG is strongly preferred for multivessel or left main disease. PCI associated with higher MACE. Heart team discussion essential; involve cardiac surgeon early.
Interpretation bands for the SYNTAX Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- DAPT Score · Coronary Artery Disease
- Mehran Score for Post-PCI Contrast Nephropathy · Coronary Artery Disease
- Canadian Cardiovascular Society (CCS) Angina Grading · Coronary Artery Disease
- Duke Treadmill Score · Coronary Artery Disease
- ARC-HBR Criteria for High Bleeding Risk in PCI · Coronary Artery Disease
- PRECISE-DAPT Score for Bleeding on DAPT · Coronary Artery Disease
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.