Correlation between B-type Natriuretic Peptide and Syntax Score in Patients of Multivessel Coronary Artery Disease Presented with Acute Coronary Syndrome

Background: The SYNTAX score measures the architectural complexity of coronary artery disease (CAD), whereas B-type natriuretic peptide (BNP) is a biomarker of ventricular stress and ischemia.  It is yet unknown how they work together to treat multivessel CAD in patients with acute coronary syndrome (ACS). Aim: To assess correlation between SYNTAX score and plasma BNP levels in multivessel CAD patients who present with ACS.  Patients and Methods: This prospective study included 60 ACS patients admitted to Zagazig University Hospital and El-Agouza Police Hospital. All patients underwent BNP measurement and coronary angiography with SYNTAX scoring. Patients were divided into two groups: Group 1 (non-multivessel CAD) and Group 2 (multivessel CAD). Clinical characteristics, risk factors, lesion complexity, BNP, and SYNTAX score were compared. Results: Multivessel disease (MVD) patients were older and predominantly male, with higher prevalence of diabetes, dyslipidemia, smoking, obesity, and LVH. They also showed significantly lower hemoglobin and higher creatinine levels. Complex lesion characteristics were more frequent in MVD group. BNP levels were markedly higher in MVD group and increased with number of diseased vessels, there was a statistically significant increase in BNP level with progression of CAD, worsening of lesion characteristics and increase in complexity and severity of lesions. BNP correlated strongly with SYNTAX score in the total cohort and within subgroups. Conclusion: BNP levels indicate the degree and complexity of CAD in ACS patients and correspond with the SYNTAX score. When combined with SYNTAX, BNP may be a straightforward supplementary tool for risk assessment and revascularization strategy guidance.