Calculated serum osmolality was independently associated with a higher risk of complex coronary lesions (SYNTAX score >22) in patients with stable coronary artery disease (OR 1.123 per mOsm/kg).
Observational (n=281)
No
Does higher calculated serum osmolality predict moderate-high SYNTAX scores in adults with stable CAD undergoing elective coronary angiography?
Calculated serum osmolality is independently associated with angiographic lesion complexity in stable CAD and may aid in preangiography risk stratification.
Odds Ratio: 1.123 (95% CI 1.07–1.184)
Absolute Event Rate: 293.2% vs 288.1%
p-value: p=<0.001
Objective: The SYNTAX score quantifies coronary lesion complexity and guides revascularization in coronary artery disease (CAD). Readily available biomarkers that reflect lesion burden may improve preangiography risk stratification. This study evaluated whether calculated serum osmolality is associated with lesion complexity in stable CAD. Methods: Adults undergoing elective coronary angiography between January and December 2023 were retrospectively analyzed. Serum osmolality was calculated as 2×Na + +BUN/2.8+Glucose/18. Patients were classified as having a low (≤22) or moderate-high (>22) SYNTAX score. Variables identified by least absolute shrinkage and selection operator (LASSO) regression were tested in multivariable logistic regression. Results: A total of 281 patients were included; 195 (69.4%) had a low SYNTAX score, and 86 (30.6%) had a moderate-high SYNTAX score. Median osmolality was significantly higher in the moderate-high group than in the low-score group (293.2 vs. 288.1mOsm/kg; p<0.001). In multivariable analysis, serum osmolality was the strongest independent predictor of a high SYNTAX score (OR, 1.123; 95% CI, 1.070–1.184; p<0.001), along with age, chronic obstructive pulmonary disease, and lipid parameters. Receiver operating characteristic analysis revealed an area under the curve of 0.75 (95% CI, 0.69–0.81). Conclusion: Calculated serum osmolality, a simple and universally available parameter, is independently associated with angiographic lesion complexity in stable CAD and may contribute to preangiography risk stratification and revascularization planning.
Tiryaki et al. (2026) conducted an observational in Stable coronary artery disease (n=281). Calculated serum osmolality vs. Low serum osmolality was evaluated on Moderate-high SYNTAX score (>22) (OR 1.123, 95% CI 1.070-1.184, p=<0.001). Calculated serum osmolality was independently associated with a higher risk of complex coronary lesions (SYNTAX score >22) in patients with stable coronary artery disease (OR 1.123 per mOsm/kg).