CHA2DS2-VASc score, a simple clinical tool for early prediction of no-reflow phenomenon in patients undergoing emergency percutaneous coronary revascularization

• Published in: Journal of cardiovascular and thoracic research Vol. 14; no. 2; pp. 122 - 127
• Main Authors: Abdul Hakeem Shaikh, Rajesh Kumar, Ali Ammar, Afzal Hussain, Muhammad Naeem Mengal, Kamran Ahmed Khan, Danish Qayyum, Jawaid Akbar Sial, Tahir Saghir, Musa Karim
• Format: Journal Article
• Language: English
• Published: Tabriz University of Medical Sciences 01-06-2022
• Subjects: cha2ds2-vasc; primary percutaneous coronary intervention; slow/no-reflow; st-segment elevation myocardial infarction
• ISSN: 2008-5117; 2008-6830
• DOI: 10.34172/jcvtr.2022.19

Introduction: Slow flow/no reflow (SF/NR) phenomenon during emergency percutaneous revascularization is a feared complication associated with increased risk of adverse outcomes.CHA2DS2-VASc score has been proposed for the risk stratification but a very limited evidences are available regarding the accuracy of this system. Therefore, we conducted this study to assess the predictive value of -VASc score for predicting SF/NR phenomenon during primary percutaneous coronary intervention (PCI). Methods: This analytical cross-sectional study included 596 consecutive patients undergoing PCI for STEMI at a tertiary care cardiac center of Karachi, Pakistan. Baseline -VASc sore was calculated and development of SF/NR phenomenon during primary PCI was recorded. Predictive value of the score was assessed through area under the curve (AUC) of receiver operating characteristic curve analysis and sensitivity and specificity were computed. Logistic regression analysis was performed to assess the predictive strength of the score. Results: A total of 596 patients were included, mean age was 56.28±11.44 years, and75.7%(451) were male. The slow/no reflow phenomenon during the procedure was observed in36.6%(218) of the patients. -VASc≥2 was observed in 50.2%(299) of the patients. The CHA2DS2-VASc score was significantly higher in SF/NR patients, 2.06±1.25 vs. 1.37±1.33; P<0.001. The AUC of CHA2DS2-VASc score was 0.652 [0.607-0.696], CHA2DS2-VASc≥2 had sensitivity and specificity of 65.6% [58.9% to 71.9%] and 58.3% [53.6% to 63.7%] respectively for predicting SF/NR. CHA2DS2-VASc≥2 was insignificant on multivariate with odds ratio of 1.48 [0.72 -3.04];P=0.283. Conclusion: CHA2DS2-VASc risk stratification system has moderate discriminating power for the stratification of SF/NR phenomenon during primary PCI.