Iranian Heart Journal

Iranian Heart Journal

Assessment of the EAS Index for Diagnosis of Coronary Artery Disease in Elective Coronary Angiography Candidates

Document Type : Original Article

Authors
Fereshteh Ghaderi 1
Sara Afshar 1
Arash Gholoobi 1
Vahid Reza Askari 2
Hoorak Poorzand 1
Navid Rabiee 1
Vafa Baradaran Rahimi 1
1 Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
2 Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Abstract
Background: Coronary artery disease (CAD) is the leading cause of mortality, and its gold standard diagnostic method is invasive coronary angiography. Nonetheless, efforts are still in progress to find noninvasive methods for diagnosing CAD. The present study aimed to determine the EAS index as a novel diagnostic tool for CAD.

Methods: This study was performed on elective coronary angiography candidates. Patients underwent transthoracic echocardiography, and the EAS index was calculated. Coronary angiography films were interpreted, and the SYNTAX score was calculated by an interventional cardiologist blinded to echocardiography results.

Results: This study enrolled 60 patients: 32 were in the CAD group, and 28 were in the normal coronary group. The median age was 53 (IQR, 18) years, and 51.7% of participants were female. The SYNTAX score in patients with CAD was calculated as 16.7 (SD, 8.08). The median EAS in the CAD group (0.18 [IQR, 0.16]) was significantly greater than in the normal coronary group (0.15 [IQR, 0.12]; P = .045). A moderate negative correlation was observed between the SYNTAX score and left atrial (LA) volume (r = −.26; P = .041), LA volume index (r = −.265; P = .04), and left ventricular systolic tissue velocity (LV S') (r = −.254; P = .05) in the CAD group. Additionally, a positive association was found between the SYNTAX score and EAS (r = .35; P = .005) in patients with CAD.

Conclusions: The EAS index was higher in patients with CAD than in those with normal coronaries, suggesting potential diagnostic utility. Its positive correlation with the SYNTAX score indicates a possible role in severity assessment. Further studies are warranted to confirm these findings. (Iranian Heart Journal 2026; 27(3): 37-48)
Keywords
coronary artery disease
echocardiography
EAS index
SYNTAX score
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Iranian Heart Journal
Volume 27, Issue 3
Summer 2026
Pages 37-48