The SYNTAX Score 2020 and its derived variants intend to provide therapeutic advice or guidance as to appropriate treatment strategies for individual patients. Their major features are described below.

Anatomic SYNTAX Score

Anatomy (ICA), population strata outcome, Population: PCI and CABG.Predicts MACCE prognosis from 1 to 5 years in the SYNTAX trial (PCI vs. CABG in three-vessel disease and left main)1-3 and mortality up to 10 years in the SYNTAXES study.


Anatomy (ICA) and comorbidity, Population: individualized outcome for “all-comers” PCI Predicts all-cause mortality at 2 years in “all-comers” PCI.

SYNTAX SCORE III (PCI & CABG decision-making)

Anatomy (CTA), comorbidity, and functionality (FFRCT), Population: PCI and CABG Treatment decision making between PCI and CABG in 3VD & LM based solely on multi-slice CT scan with FFRCT in the SYNTAX III REVOLUTION trial.



Anatomy (ICA and CTA) and functionality (iFR, FFR, FFRCT, QFR), Population: PCI and CABG Treatment decision making based on anatomy and functionality.

SYNTAX SCORE II (PCI & CABG decision-making)

Anatomy (ICA) and comorbidity, Population: PCI versus CABG. Predicts 4-year all-cause mortality in the SYNTAX trial.
* The SYNTAX Score II will be superseded by SYNTAX Score 2020.

SYNTAX SCORE III (planning & execution CABG)

Anatomy (CTA), comorbidity, and functionality (FFRCT), Population: CABG Planning and execution of surgery in 3VD & LM applying SYNTAX Score III erived solely on CTA scan with FFRCT (the FASTTRACK CABG trial, First in men).


SYNTAX Score 2020

Anatomy (ICA) and comorbidity, Population: PCI versus CABG Predict 5-year MACE and 10-year all-cause mortality based on cross validation in the SYNTAX trial and on external validation in the FREEDOM, BEST, and PRECOMBAT trials


**CABG: coronary artery bypass grafting; CTA: computed tomography angiography; FFR: fractional flow reserve; FFRCT: fractional flow reserve derived from CTA; ICA: invasive coronary angiography; iFR: instantaneous wave-free ratio; QFR: quantitative Flow Ratio; PCI: percutaneous coronary intervention; 3VD: three-vessel disease; LM: left main:.