Impact of the caFFR-Guided Functional SYNTAX Score on Ventricular Tachycardia/Fibrillation Development in Patients With Acute Myocardial Infarction

AIMS: To explore the relationship between the severity of coronary artery disease (CAD) and the occurrence of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with acute myocardial infarction (AMI). METHODS: We retrospectively enrolled 705 patients with AMI, who were hospitalized and underwent percutaneous coronary intervention (PCI), in Nanfang Hospital from July 2017 to July 2020. Logistic regression analysis and backward stepwise approach were taken to select the correlation factors. The left and the receiver operating characteristic curves (ROC) analysis were plotted to observe the discriminative power of the SYNTAX score (SS)/caFFR-guided functional SS (FSS(caFFR)) on the incident VT/VF. RESULTS: About 58 (8.2%) patients experienced life-threatening VT/VF. The FSS(caFFR) (OR: 1.155; 95% CI: 1.047 to 1.273; p = 0.004) was an independent predictor of VT/VF after AMI. The ROC analysis showed that the discriminative power of FSS(caFFR) on the incident VT/VF was significantly better than SS (0.759 vs.0.695, p < 0.0001). Patients with VT/VF were categorized into 2 groups according to the interval between the onset of AMI and the VT/VF. The logistic regression analysis revealed that FSS(caFFR) was a significant independent correlation of early- and late-VT/VF. CONCLUSION: The incident VT/VF in patients with AMI is closely associated with the severity of CAD evaluated by SS and FSS(caFFR). Compared to SS, FSS(caFFR) has a higher correlation with VT/VF, and FSS(caFFR) was demonstrated to be an independent correlation factor of incident VT/VF after AMI.