Author/Authors :
mirbolouk, fardin guilan university of medical sciences - school of medicine, cardiovascular diseases research center - department of cardiology, Rasht, Iran , gholipour, mahboobeh guilan university of medical sciences - school of medicine, cardiovascular diseases research center - department of cardiology, Rasht, Iran , salari, arsalan guilan university of medical sciences - school of medicine, cardiovascular diseases research center - department of cardiology, Rasht, Iran , shakiba, maryam guilan university of medical sciences - cardiovascular diseases research center, Rasht, Iran , kheyrkhah, jalal guilan university of medical sciences - school of medicine, cardiovascular diseases research center - department of cardiology, Rasht, Iran , nikseresht, vahid guilan university of medical sciences - healthy heart research center, Rasht, Iran , sotoudeh, nozar guilan university of medical sciences - cardiovascular diseases research center - department of cardiology, Rasht, Iran , moghadam, negar guilan university of medical sciences - cardiovascular diseases research center - department of cardiology, Rasht, Iran , mirbolouk, mohammad jaafar guilan university of medical sciences - cardiovascular diseases research center - department of cardiology, Rasht, Iran , moayeri far, mani guilan university of medical sciences - cardiovascular diseases research center - department of cardiology, 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.
Keywords :
CHA2DS2 , VASc Score , STEMI , Primary PCI , No , reflow
