The relationship between H2FPEF and SYNTAX scores in patients with Acute Coronary Syndrome

Background: Acute coronary syndrome (ACS) encompasses unstable angina and myocardial infarctions (MI), both ST-elevation (STEMI) and non-ST-elevation (NSTEMI). This study aimed to evaluate the severity of coronary artery disease (CAD) in ACS patients by comparing the H2FPEF score with the SYNTAX score. Methods: This prospective observational study included 100 patients with ACS who underwent coronary angiography within two days of hospital admission. Based on SYNTAX score, patients were categorized into two groups: Group I (SYNTAX ≤ 22) and Group II (SYNTAX > 22). Echocardiographic and clinical data were collected and analyzed. Results: Group II patients showed significantly lower mean LVEF and TAPSE (p < 0.001) and higher E/e′ ratio and PASP (p < 0.05). Patients with major adverse cardiovascular and cerebrovascular events (MACCE) had notably higher mean H2FPEF scores than those without events. A strong correlation was found between higher H2FPEF and SYNTAX scores, indicating that H2FPEF can serve as a predictive marker for CAD severity and short-term outcomes. Conclusion: The H2FPEF score is a simple and effective tool for assessing CAD severity and short-term prognosis in ACS patients. Scores ≥2 are significantly associated with higher SYNTAX scores and increased risk of MACCE at 30-day follow-up, suggesting its utility in early risk stratification.