Association Between SYNTAX Score and Leukoglycemic Index In Patients Wiht Acute Coronary Syndrome
Conditions: Acute Coronary Syndromes (ACS)
Sponsor: Kırıkkale University

08.02.2026 
KIRIKKALE UNIVERSITY 
FACULTY OF MEDICINE 
DEPARTMENT OF CARDIOLOGY 
STUDY DOCUMENTS OF 
“Association Between SYNTAX Score and Leukoglycemic Index 
In Patients Wiht Acute Coronary Syndrome” 
PROTOCOL ID: 2024.05.19 
NCT NUMBER: NCT07276256 
DATE OF ISSUE: 15.12.2025 
RESPONSIBLE RESEARCHER: RUKİYE GÖNEN ÖZDEMİR, 
MD 

08.02.2026 
Study Design and Methods  
Our study was designed as a single-center, retrospective, cross-sectional, observational study. 
It was conducted after approval by the Ethics Committee of the Faculty of Medicine, Kırıkkale 
University. Patients who presented to the emergency department or cardiology outpatient clinic 
between 2015 and 2023 with suspected acute coronary syndrome (ACS) and underwent 
coronary angiography were retrospectively evaluated. 
In this study, the SYNTAX scores of patients diagnosed with ACS and who underwent coronary 
angiography, followed by a decision for Percutaneous Coronary Intervention (PCI) or Coronary 
Artery Bypass Grafting (CABG), were calculated and their relationship with the Leucoglycemic 
Index (LGI) was investigated. 
Between 2015 and 2023, a total of 1209 patients presenting to the cardiology outpatient clinic 
or emergency department of Kırıkkale University Faculty of Medicine with ACS were 
retrospectively screened. After applying exclusion criteria, 552 patients were included in the 
study. 
Coronary angiography images were retrieved from the hospital’s Picture Archiving and 
Communication System (PACS). Using quantitative coronary angiography (QCA), lesions 
were defined as significant obstructive coronary artery disease (CAD) if there was >50% 
stenosis in the left main coronary artery (LMCA) or >70% stenosis in coronary arteries with a 
diameter >1.5 mm. SYNTAX scores were calculated using the official SYNTAX Score 
Calculator website. 
Standard laboratory tests performed at admission were retrospectively obtained from the 
hospital information system. Complete blood count and biochemical data were recorded. The 
LGI value was calculated as the product of blood glucose (mg/dL) and leukocyte count (10⁹/L), 
divided by 1000. 
Formula: 
LGI = [Glucose (mg/dL) * Leukocyte count (10⁹/L)] / 1000 
Inclusion Criteria 
• 
Adults aged ≥18 years 
• 
Patients undergoing coronary angiography due to acute coronary syndrome 
• 
Non-obese patients 
Exclusion Criteria 
• 
Patients <18 years of age 
• 
Patients with diabetes mellitus (diagnosed by ongoing oral or insulin therapy and/or 
fasting glucose ≥126 mg/dL with HbA1c ≥6.5%) 
• 
Patients with atrial fibrillation, pacemaker history, asthma, pulmonary hypertension, 
pregnancy, anemia, malignancy, rheumatoid arthritis, peripheral artery disease 

08.02.2026 
• 
Obese patients (BMI >30 kg/m²) 
• 
Patients with unavailable medical records 
Study Variables 
• 
Independent variables: Age, sex, comorbidities, laboratory results (white blood cell 
count, hemoglobin, platelet count, glucose), SYNTAX score 
• 
Dependent variables: Admission hemogram and glucose values 
Statistical Analysis 
Data analysis was performed using SPSS for Windows, version 25. 
• 
Categorical variables were expressed as frequencies and percentages. 
• 
Continuous variables were expressed as mean ± standard deviation or median 
(minimum–maximum), depending on distribution. 
• 
Relationships between categorical variables were assessed using the Chi-square test. 
• 
For continuous variables, normality was tested with the Shapiro–Wilk test and 
homogeneity of variance with the Levene test. 
• 
Normally distributed data were compared using the independent samples Student’s t-
test; non-normally distributed data were analyzed with the Mann–Whitney U test. 
• 
The relationship between LGI and SYNTAX score was evaluated using Pearson 
correlation analysis. 
• 
Logistic regression analysis was used to identify predictors of moderate-to-high 
SYNTAX scores. Odds ratios (OR) and confidence intervals (CI) were calculated, with 
non-critical CAD as the reference.  
o In the unadjusted model, only LGI was used to predict CAD severity. 
o In the adjusted model, age, HbA1c, creatinine, and hypertension were included 
in multivariate logistic regression. 
• 
Linear regression analysis was also performed to assess the relationship between LGI 
and CAD severity. 
• 
Results were interpreted according to p-values, with p < 0.05 considered statistically 
significant. 
Ethics Approval 
The study was approved by the Non-Interventional Research Ethics Committee of Kırıkkale 
University Faculty of Medicine on May 22, 2024, with decision number 2024.05.19.