Paper Information

Journal:   JOURNAL OF CARDIOVASCULAR AND THORACIC RESEARCH   2018 , Volume 10 , Number 1; Page(s) 46 To 52.
 
Paper: 

CHA2DS2-VASC SCORE PREDICT NO-REFLOW PHENOMENON IN PRIMARY PERCUTANEOUS CORONARY INTERVENTION

 
 
Author(s):  MIRBOLOUK FARDIN, GHOLIPOUR MAHBOOBEH, SALARI ARSALAN, SHAKIBA MARYAM, KHEYRKHAH JALAL, NIKSERESHT VAHID, SOTOUDEH NOZAR*, MOGHADAM NEGAR, MIRBOLOUK MOHAMMAD JAAFAR, MOAYERI FAR MANI
 
* CARDIOVASCULAR DISEASES RESEARCH CENTER, DEPARTMENT OF CARDIOLOGY, GUILAN UNIVERSITY OF MEDICAL SCIENCES, RASHT, IRAN
 
Abstract: 

Introduction: No-reflow is one of the major complications of primary percutaneous coronary intervention (PCI) in patients with acute ST elevation myocardial infarction. This phenomenon is associated with adverse outcomes in these patients. In the current study, we evaluated the effectiveness of CHA2DS2-VASc score in predicting no-reflow phenomenon. CHA2DS2-VASc score is a risk stratification method to estimate the risk of thromboembolism in patients with atrial fibrillation.
Methods: In total, 396 patients with ST elevation myocardial infarction who had undergone primary PCI were evaluated in our study. Based on post interventional TIMI flow rate results, the patients were divided into two groups: control group (294 patients) and no-reflow group (102 patients). The CHA2DS2-VASc score was calculated for each participant. Multivariate regression analysis was performed to determine the predictive value of this score.
Results: Our findings showed that CHA2DS2-VASc score can predict no-reflow independently (odds ratio [OR]: 3.06, 95% CI: 2.23-4.21, P<0.001). Moreover, lower systolic blood pressure, higher diastolic blood pressure, grade 0 initial TIMI flow rate and smaller stent size were other independent predictors of the no-reflow in our study. We also defined a cut off value of?2 for the CHA2DS2-VASc score in predicting the no-reflow with a sensitivity of 88% and specificity of 67%, area under curve: 0.83 with 95% CI (0.79-0.88).
Conclusion: The CHA2DS2-VASc score could be used as a simple applicable tool in the prediction of no-reflow before primary PCI in the acute ST elevation myocardial infarction patients.

 
Keyword(s): CHA2DS2-VASC SCORE, STEMI, PRIMARY PCI, NO-REFLOW
 
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