What is the clinical evidence from this study?

Study design: Cohort. Population: Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) (n=163). Intervention: Residual SYNTAX score (rSS) vs. Lower rSS / Complete revascularization. Primary outcome: Composite of cardiovascular death, recurrent myocardial infarction, ischemic stroke, and repeat revascularization (OR 1.096, 95% CI 1.001-1.182, p=0.048).

What question did this study set out to answer?

To assess the prognostic significance of residual SYNTAX score in NSTEMI patients with preserved or mildly reduced ejection fraction and type 2 diabetes.

July 14, 2026Journal of Cardiovascular Intervention0 citationsOpen Access

Prognostic Value of the Residual SYNTAX Score in Patients With Non–ST-Segment Elevation Myocardial Infarction, Type 2 Diabetes Mellitus, and Preserved or Mildly Reduced Ejection Fraction: A Six-Month Follow-Up Study From Central Asia

РТРаиса ТригуловаMinistry of Health of the Republic of Uzbekistan DAD. AkhmedovaTashkent Pediatric Medical Institute AIAlisher IkramovNational University of Uzbekistan

Key Result

Each 1-unit increase in the residual SYNTAX score was associated with a 9.6% higher risk of adverse cardiovascular events (OR 1.096) at 6 months.

Key Points

To assess the prognostic significance of residual SYNTAX score in NSTEMI patients with preserved or mildly reduced ejection fraction and type 2 diabetes.
Prospective cohort study with 163 patients diagnosed with NSTEMI.
Patients underwent coronary angiography and echocardiographic assessment.
Residual SYNTAX score calculated post-percutaneous coronary intervention.
Each 1-unit increase in residual SYNTAX score increased adverse event risk by 9.6% (OR 1.096, P=0.048).
NT-proBNP > 990 pg/mL predicted repeat revascularization (OR 1.082, P=0.002).
Patients with adverse outcomes had lower ejection fraction (41.4% vs. 48.4%, P=0.001) and higher E/e′ ratios (11.8 vs. 8.6, P=0.025).

Study Design

Type

Cohort (n=163)

Multicenter

Structured PICO

Does the residual SYNTAX score predict adverse cardiovascular outcomes in patients with NSTEMI and preserved or mildly reduced LVEF?

Population

163 adults with NSTEMI and preserved or mildly reduced left ventricular ejection fraction, followed for 6 months.

Exposure

Calculation of the residual SYNTAX score (rSS) after percutaneous coronary intervention (PCI) to quantify the extent of untreated coronary lesions.

Outcome

Composite of cardiovascular death, recurrent myocardial infarction, ischemic stroke, and repeat revascularization during the 6-month follow-up period, adjudicated by an independent committee.composite

In patients with NSTEMI and preserved or mildly reduced LVEF, incomplete revascularization quantified by the residual SYNTAX score is an independent predictor of 6-month adverse cardiovascular events.

Main Result

Odds Ratio: 1.096 (95% CI 1.001–1.182)

p-value: p=0.048

Limitations

Coronary angiography and PCI were not performed in all patients due to clinical and patient-related factors.
rSS could be calculated in only 85 patients.
T2DM was highly prevalent but not a required inclusion criterion.
A small subset in the adverse outcome group had borderline or slightly lower LVEF values at follow-up assessment.

Abstract

Background: To evaluate the prognostic significance of the residual SYNTAX score (rSS) for predicting adverse cardiovascular outcomes in patients with non-ST elevation myocardial infarction (NSTEMI) and preserved or mildly reduced left ventricular ejection fraction (LVEF; ≥ 40%), among whom type 2 diabetes mellitus was a prevalent comorbidity, with a focus on the interplay among incomplete revascularization, myocardial dysfunction, and neurohormonal activation.Methods: This prospective cohort study included 163 patients with NSTEMI.Patients underwent coronary angiography, comprehensive echocardiographic assessment including diastolic function parameters, and biomarker analysis with an emphasis on heart failure markers.The rSS was calculated after percutaneous coronary intervention.Outcomes included cardiovascular death, recurrent myocardial infarction, ischemic stroke, heart failure hospitalization, and repeat revascularization during the 6-month follow-up period. Results:The rSS and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were independent predictors of adverse events.Each 1-unit increase in rSS was associated with a 9.6% higher risk (odds ratio OR, 1.096; P = 0.048).NT-proBNP > 990 pg/mL predicted the need for repeat revascularization (OR, 1.082; P = 0.002).Patients with adverse outcomes had significantly lower LVEF (41.4% vs. 48.4%,P = 0.001), higher E/e′ ratios indicating diastolic dysfunction (11.8 vs. 8.6, P = 0.025), and larger left atrial volumes, reflecting elevated filling pressures.Receiver operating characteristic analysis showed moderate discriminative ability (area under the receiver operating characteristic curve = 0.72).

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