title: CHA2DS2-VASc Score is a Predictor of No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Intervention.
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.
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey gipek@partners.org.
authors.forename: Gokturk
authors.initials: G
authors.lastname: Ipek
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Mehmet B
authors.initials: MB
authors.lastname: Karatas
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Altug
authors.initials: A
authors.lastname: Osken
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Keskin
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Oz
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Tanik
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Mert Ilker
authors.initials: MI
authors.lastname: Hayiroglu
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Hale Yilmaz
authors.initials: HY
authors.lastname: Yaka
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Ozturk
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bolca
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D003326:Coronary Circulation; D003661:Decision Support Techniques; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: CHA2DS2-VASc score; STEMI; in-hospital mortality; no-reflow; primary PCI