European Radiology

, Volume 28, Issue 5, pp 2151–2158 | Cite as

Accuracy of computed tomography for selecting the revascularization method based on SYNTAX score II

  • Si Eun Lee
  • Kyunghwa Han
  • Jin Hur
  • Young Jin Kim
  • Hye-Jeong Lee
  • Yoo Jin Hong
  • Dong Jin Im
  • Byoung Wook ChoiEmail author



The application of SYNTAX score II based on coronary CT angiography (CCTA) for selecting further treatment options has not been studied. This study aimed to investigate the diagnostic performance of CCTA combined with SYNTAX score II for selecting the revascularization method compared with invasive coronary angiography (ICA) based on 2014 European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) guidelines.


From January–May 2011, 160 patients who underwent both CCTA and ICA within 30 interval days were included. The diagnostic performance of CCTA, CCTA plus CT-SYNTAX score I and CT-SYNTAX score II was analysed using ICA counterparts as references.


Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CCTA plus CT-SYNTAX I for selecting coronary artery bypass grafting (CABG) candidates using ICA plus ICA-SYNTAX I as reference, were 70.6 %, 95.8 %, 66.7 %, 96.5 % and 93.1 %, respectively. The diagnostic performance of CCTA plus CT-SYNTAX II showed improvement with values of 83.3 %, 97.3 %, 71.4 %, 98.6 % and 96.3 %, respectively, using ICA plus ICA-SYNTAX II as reference.


CCTA combined with CT-SYNTAX score II is an accurate method for selecting CABG surgery candidates compared with ICA-SYNTAX score II.

Key points

SYNTAX plus CCTA can be highly specific for selecting the revascularization method.

SYNTAX II was complemented by including clinical considerations to SYNTAX I.

CCTA plus CT-SYNTAX II is an accurate method for selecting CABG candidates.


Coronary computed tomography angiography SYNTAX score I SYNTAX score II Revascularization Coronary artery bypass grafting 



Area under curve


Coronary artery bypass grafting


Coronary artery disease


Coronary computed tomography angiography


Confidence interval


Chronic obstructive pulmonary disease




European Society of Cardiology/European Association for Cardio-Thoracic Surgery


Generalized estimating equations


Glomerular filtration rate


Invasive coronary angiography


Left main




Negative predictive value


Percutaneous coronary intervention


Positive predictive value


Peripheral vascular disease


Three-vessel disease



This study was supported by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2010729).

Compliance with ethical standards


The scientific guarantor of this publication is Byoung Wook Choi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• diagnostic or prognostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Department of Radiology, Severance Hospital, Research Institute of Radiological ScienceYonsei University, College of MedicineSeoulKorea

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