Evidence map›Paper›PMID 41636974›Full record

SynthesisThe international journal of cardiovascular imaging2026

Comparison of SYNTAX scores between coronary CT angiography and invasive coronary angiography: a systematic review and meta-analysis.

Hazhir Moradi, Seyed Reza Tabibian, Mahdi Saberi Pirouz, Elahe Zare-Farashbandi, Amirreza Sajjadieh Khajouei

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The international journal of cardiovascular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Hazhir MoradiNosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.ORCID http://orcid.org/0000-0002-3306-7493
Seyed Reza TabibianDepartment of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Mahdi Saberi PirouzElectrophysiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Elahe Zare-FarashbandiHealth Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.ORCID http://orcid.org/0000-0003-3066-6324
Amirreza Sajjadieh KhajoueiDepartment of Internal Medicine, Isfahan University of Medical Sciences, Hezar Jarib St, Isfahan, Iran. amirsajjadieh@yahoo.com.ORCID http://orcid.org/0000-0001-6383-5660

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Accurate assessment of coronary lesion complexity is essential for guiding revascularization strategies in patients with coronary artery disease. The SYNTAX score, originally derived from invasive coronary angiography (ICA), plays a key role in clinical decision-making. With advancements in cardiac computed tomography angiography (CCTA), its potential as a non-invasive tool for SYNTAX scoring has gained interest, but discrepancies between modalities remain uncertain. To systematically compare SYNTAX scores obtained by CCTA versus ICA and evaluate their concordance, with implications for clinical decision-making. We conducted a systematic review and meta-analysis of studies published between 2013 and 2024 comparing SYNTAX scores derived from CCTA and ICA in the same adult populations. Databases including PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched through January 2025. The primary outcome was the pooled standardized mean difference (Hedges' g) in SYNTAX scores between modalities. Risk of bias was assessed using QUADAS-2, and meta-regression explored potential sources of heterogeneity. Thirteen studies with a total of over 1,800 patients met inclusion criteria. The pooled analysis demonstrated a statistically significant underestimation of SYNTAX scores by CCTA compared to ICA (Hedges' g = - 0.121; 95% CI: -0.185 to - 0.056; p < 0.01). Heterogeneity was moderate (I² = 30.7%) after exclusion of one outlier. Meta-regression revealed no significant impact of publication year, scanner generation, or sample size on effect size. Several studies highlighted meaningful discrepancies in SYNTAX classification near critical decision thresholds (22 and 32). Funnel plot symmetry and Q-Q plot normality suggested minimal publication bias. CCTA systematically underestimates SYNTAX scores compared to ICA, which may impact treatment decisions in patients with complex coronary artery disease. While CCTA offers a promising non-invasive alternative, clinicians should interpret CCTA-derived SYNTAX scores with caution-particularly in borderline cases where therapeutic strategies may differ. Further standardization of scoring protocols and incorporation of functional imaging tools such as CT-FFR are warranted.

Indexed as

Computed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseCoronary VesselsAdultAgedAged, 80 and overClinical RelevanceFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisReproducibility of ResultsSeverity of Illness IndexCoronary artery diseaseCoronary computed tomography angiographyCT-FFRInvasive coronary angiographyMeta-analysisRevascularizationSYNTAX score

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.