Association of Calculated Serum Osmolality with High-complexity Coronary Lesions: Insights from the SYNTAX Score
Muhammet Mücahit Tiryaki1
, Uğur Karagöz2, Cemalettin Yılmaz3, Aslı Nalbant4, Ahmet Karaduman5, Enis Behçet Ağırdıcı6, Mustafa Ozan Gürsoy7, Sadık Volkan Emren2
1Department of Cardiology, Muş State Hospital, Muş, Türkiye
2Department of Cardiology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye
3Department of Cardiology, Yalova University, Yalova, Türkiye
4Department of Cardiology, Bağcılar Training and Research Hospital, İstanbul, Türkiye
5Department of Cardiology, Kartal Koşuyolu Training and Research Hospital, İstanbul, Türkiye
6Department of Cardiology, İzmir City Hospital, Izmir, Türkiye
7Department of Cardiology, University of Health Sciences, İzmir, Türkiye
Keywords: Coronary artery disease; serum osmolality; SYNTAX score.
Abstract
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.
Cite This Article: Tiryaki MM, Karagöz U, Yılmaz C, Nalbant A, Karaduman A, Ağırdıcı EB, et al. Association of Calculated Serum Osmolality with High-complexity Coronary Lesions: Insights from the SYNTAX Score. Koşuyolu Heart J 0000;00(0):1–8