AI-based CT-SYNTAX score shows moderate agreement with invasive angiography in complex CAD

Retrospective study: AI-based CT-SYNTAX score (n=411) showed moderate agreement with invasive angiography (κ=0.37, 69.2% agreement) and small mean bias (0.22; 95% limits -19.19 to 19.63). Processing time in left main/three-vessel disease: 49.2s. Treatment recommendation agreemen…

• AI-CT-SS had similar accuracy to manual CT-SS but was significantly faster in the left main/three-vessel disease subgroup (49.2 ± 13.9 s vs manual; P<0.001).
• Agreement for categorical risk classification was low-moderate (κ=0.37) and treatment recommendation agreement modest (κ=0.27), indicating the tool is supportive, not standalone.
• Single-center retrospective design; prospective validation is needed.

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