CHA2DS2-VASc Score as a Predictor to No-Reflow Phenomenon in Primary Percutaneous Coronary Intervention in ST Segment Elevation Patients

Background: Primary PCI can be defined as coronary angioplasty/stenting Without prior administration of fibrinolytic agents or GPIIb/IIIa antagonists. This study aimed to evaluate the CHA2DS2-VASc score as a simplified applicable tool to predict the no-reflow among patients with STEMI who will undergo primary PCI. Methods: This Cross-sectional study included 119 patients presenting with ST Segment elevation who underwent primary PCI. Patients were divided into 2 groups according to the incidence of no reflow into 2 groups: Group 1 (with no reflow) (n=13 (10.92%)). Group 2 (without no-reflow) (n=106 (89.08%). Results: CHA2DS2-VASc score can significantly predict the incidence of no reflow with AUC of 0.991, P value of <0.001, at cutoff value >3, with 100% sensitivity, 98.11% specificity, 86.7% PPV and 100% NPV. The univariate logistic regression analysis showed that age 65-74 years, age ≥75, history of stroke, CHA2DS2-VASc score, stent diameter, stent length and diagnosis were the significant predictors of the incidence of no reflow. Conclusion: The study demonstrates a significant association between higher CHA2DS2-VASc scores and the occurrence of the no-reflow phenomenon in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The findings suggest that the CHA2DS2-VASc score, originally developed for predicting thromboembolic events in atrial fibrillation, holds promise as a simplified and applicable tool for identifying individuals at greater risk of microvascular dysfunction.