CHADS₂-VASc Score can predict no-reflow in the settings of acute ST-elevated myocardial infarction

K.Ocal Karabay, Bayram Bagirtan, Behzat Ozdemir, Busra Tozlu, Muhammed Bayram, Sati Selda Pirinc, Sukru Cetin, Onder Demiroz

Abstract

Background: No-reflow (NR) is one of the serious complications of primary percutaneous coronary intervention (PCI) and it is related to higher short- and long-term mortality. In this study, we aim to determine NR possibility with a scoring system.
Methods: This retrospective, single-center study included consecutive patients diagnosed with acute ST- segment elevation myocardial infarction (STEMI) and treated by PCI, between May 2019 and May 2024. Results: A total 1050 patients were included: patients were divided to two groups according to the final coronary flow: NR group (n = 139) and control group (n = 930). CHADS2-VASc score was calculated for all the patients and multivariable regression and receiver operating characteristic curve analyses were conducted to determine the independent predictors of NR and cutoff value of CHA2D-VASc score. CHAD₂-VASc cut-off values of 2 have a sensitivity of 84.2% and a specificity of 30% (The area under the curve (AUC) was calculated to be 0.615).
Conclusion: A CHA2DS₂-VASc score ≥ 2 may serve as a valuable predictive tool for identifying the occurrence of NR in patients with STEMI. The sensitivity demonstrated in our study offers clinicians a practical approach for risk stratification and management of patients at risk of developing NR.