title: Non-invasive Heart Team assessment of multivessel coronary disease with coronary computed tomography angiography based on SYNTAX score II treatment recommendations: design and rationale of the randomised SYNTAX III Revolution trial.
abstract: OBJECTIVE
  The aim of this study was to investigate whether a Heart Team decision-making process regarding the choice of revascularisation strategy based on non-invasive coronary multislice computed tomography angiography (MSCT) assessment of coronary artery disease (CAD) is equivalent to the standard-of-care invasive angiography-based assessment in patients with multivessel CAD.
  
  
  RESULTS
  The SYNTAX III Revolution trial is a prospective, multicentre, all-comers randomised trial that will randomise two Heart Teams to select between surgical and percutaneous treatment according to either an invasive conventional angiography or a non-invasive MSCT angiography assessment in patients with multivessel CAD. The treatment selection by each Heart Team will be guided by the SYNTAX score II calculation. The primary endpoint is the level of agreement according to kappa of the initial decision by the Heart Teams on the modality of the revascularisation based on MSCT and angiography assessments. Secondary endpoints include agreement on the number of vessels requiring treatment and the coronary segments in need of revascularisation.
  
  
  CONCLUSIONS
  The SYNTAX III Revolution trial will provide valuable information regarding the ability of a purely non-invasive coronary anatomy assessment to select accurately the most appropriate revascularisation strategy for patients with multivessel CAD.
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Rafael
authors.initials: R
authors.lastname: Cavalcante
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Yohei
authors.initials: Y
authors.lastname: Sotomi
authors.forename: Carlos
authors.initials: C
authors.lastname: Collet
authors.forename: Brian
authors.initials: B
authors.lastname: Thomsen
authors.forename: Campbell
authors.initials: C
authors.lastname: Rogers
authors.forename: Yaping
authors.initials: Y
authors.lastname: Zeng
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioglu
authors.forename: Taku
authors.initials: T
authors.lastname: Asano
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Miyasaki
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abdelghani
authors.forename: Marie-Angèle
authors.initials: MA
authors.lastname: Morel
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D000072226:Computed Tomography Angiography / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index