CHA2DS2-VASc Score is a Predictor of No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Intervention

Angiology. 2016 Oct;67(9):840-5. doi: 10.1177/0003319715622844. Epub 2015 Dec 17.

Abstract

Thrombosis and distal embolization play crucial role in the etiology of no-reflow. CHA2DS2-VASc score is used to estimate the risk of thromboembolism in patients with atrial fibrillation. We tested the hypothesis that CHA2DS2-VASc can predict no-reflow among patients who underwent primary percutaneous coronary intervention (PCI). A total number of 2375 consecutive patients with ST-segment elevation myocardial infarction were assessed for the study. Patients were divided into 2 groups as no-reflow (n = 111) and control (n = 1670) groups according to post-PCI no-reflow status. CHA2DS2-VASc scores were calculated for all patients. CHA2DS2-VASc scores were significantly higher in the no-reflow group compared to the control group. After a multivariate regression analysis, CHA2DS2-VASc score remained as an independent predictor (odds ratio: 1.58, 95% confidence interval: 1.33-1,88, P < .001) of no-reflow. Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥2 as a predictor of no-reflow with a sensitivity of 66% and a specificity of 59%. Moreover, in-hospital mortality was also associated with significantly higher CHA2DS2-VASc scores. In conclusion, CHA2DS2-VASc score is associated with higher risk of no-reflow and in-hospital mortality rates in patients who underwent primary PCI.

Keywords: CHA2DS2-VASc score; STEMI; in-hospital mortality; no-reflow; primary PCI.

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Chi-Square Distribution
  • Computed Tomography Angiography
  • Coronary Circulation
  • Decision Support Techniques*
  • Female
  • Hospital Mortality
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • No-Reflow Phenomenon / diagnostic imaging
  • No-Reflow Phenomenon / etiology*
  • No-Reflow Phenomenon / mortality
  • No-Reflow Phenomenon / physiopathology
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / mortality
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / therapy*
  • Treatment Outcome