Prognostic Implication of a CT-FFR-Based Functional SYNTAX Score in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention
- 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
- 2Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC 29425, USA
- 3Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Abstract
Background: This study aims to investigate the value of a SYNTAX score (SS) based on coronary computed tomographic angiography (cCTA)-derived fractional flow reserve (CT-FFR), termed “Functional SYNTAX score” (FSSCTA), to predict major adverse cardiovascular events (MACEs) in patients undergoing percutaneous coronary intervention (PCI). Methods: This cohort study included 876 patients who underwent cCTA and underwent PCI within 30 days during 2016–2020. CT-FFR was calculated by a machine learning algorithm. All 876 patients were divided into a low-risk group (≤22) and an intermediate-to-high-risk group (>22) with cCTA-based SS (SSCTA) as the control. Results: Based on the FSSCTA, 10.4% (91/876) of patients were reclassified to the low-risk group, and 2.9% (25/876) of patients were reclassified to the intermediate-to-high-risk group. MACEs occurred in 16.6% (145/876) of patients over a median follow-up period of 19.4 months. FSSCTA and invasive coronary angiography-based SS (SSICA) were independently associated with the risk of MACEs regardless of whether they were in continuous or categorical form (FSSCTA: c continuous HR 1.082, 95% CI 1.038–1.128; categorical HR 1.865, 95% CI 1.138–2.305. SSICA: continuous HR 1.045, 95% CI 1.012–1.079; categorical HR 1.520, 95% CI 1.128–2.048). FSSCTA showed the best predictive power for MACEs compared with SSCTA and SSICA (all comparisons with FSSCTAp < 0.05). Conclusions: FSSCTA, SSCTA and SSICA were all independent predictors of MACEs in patients undergoing PCI, and FSSCTA showed a significantly better predictive value for MACEs than SSCTA and SSICA.
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BibTeX
@article{shao2026prognostic,
title = {{Prognostic Implication of a CT-FFR-Based Functional SYNTAX Score in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention}},
author = {Qiaoyu Shao and Uwe Joseph Schoepf and Xiaoteng Ma and Lei Xu and Yujie Zhou and Fei Gao and Zhijian Wang},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207826},
url = {https://www.mdpi.com/2077-0383/15/20/7826},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prognostic Implication of a CT-FFR-Based Functional SYNTAX Score in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention
AU - Qiaoyu Shao
AU - Uwe Joseph Schoepf
AU - Xiaoteng Ma
AU - Lei Xu
AU - Yujie Zhou
AU - Fei Gao
AU - Zhijian Wang
PY - 2026
DA - 2026/10/10
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207826
UR - https://www.mdpi.com/2077-0383/15/20/7826
AB - Background: This study aims to investigate the value of a SYNTAX score (SS) based on coronary computed tomographic angiography (cCTA)-derived fractional flow reserve (CT-FFR), termed “Functional SYNTAX score” (FSSCTA), to predict major adverse cardiovascular events (MACEs) in patients undergoing percutaneous coronary intervention (PCI). Methods: This cohort study included 876 patients who underwent cCTA and underwent PCI within 30 days during 2016–2020. CT-FFR was calculated by a machine learning algorithm. All 876 patients were divided into a low-risk group (≤22) and an intermediate-to-high-risk group (>22) with cCTA-based SS (SSCTA) as the control. Results: Based on the FSSCTA, 10.4% (91/876) of patients were reclassified to the low-risk group, and 2.9% (25/876) of patients were reclassified to the intermediate-to-high-risk group. MACEs occurred in 16.6% (145/876) of patients over a median follow-up period of 19.4 months. FSSCTA and invasive coronary angiography-based SS (SSICA) were independently associated with the risk of MACEs regardless of whether they were in continuous or categorical form (FSSCTA: c continuous HR 1.082, 95% CI 1.038–1.128; categorical HR 1.865, 95% CI 1.138–2.305. SSICA: continuous HR 1.045, 95% CI 1.012–1.079; categorical HR 1.520, 95% CI 1.128–2.048). FSSCTA showed the best predictive power for MACEs compared with SSCTA and SSICA (all comparisons with FSSCTAp < 0.05). Conclusions: FSSCTA, SSCTA and SSICA were all independent predictors of MACEs in patients undergoing PCI, and FSSCTA showed a significantly better predictive value for MACEs than SSCTA and SSICA.
SN - 2077-0383
ER -