Predictive value of the Novel CHA2DS2-VASc-HSF-TT Score for No-reflow in Patients Undergoing Primary and Post-thrombolysis Percutaneous Coronary Intervention | ||
| Zagazig University Medical Journal | ||
| Article 27, Volume 31, Issue 6, June 2025, Pages 2483-2493 PDF (1.02 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.376659.3912 | ||
| Authors | ||
| Islam Ghanem1; Mohamed Samy* 2; Nader Talat Kandeel3; Khaled Fotouh Fotouh4; Hala Gouda Abomandour5 | ||
| 1Assistant Professor of Cardiology, Faculty of medicine, Zagazig university | ||
| 2Cardiology Department, Faculty of Medicine, Zagazig University | ||
| 3cardiovascular ,faculty of medicine,zagazig university ,sharkia,cairo | ||
| 4Cardiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||
| 5Cardiology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt | ||
| Abstract | ||
| Background: During primary PCI, coronary no-reflow occurs when microvascular obstruction persists despite open epicardial circulation. The CHA2DS2-VASc-HSF score, used to assess thromboembolic risk in atrial fibrillation, correlates also with no-reflow risk. This study aims to evaluate the novel CHA2DS2-VASc-HSF-TT score's predictive value for no-reflow in STEMI patients undergoing primary PCI. Methods: This study at Zagazig University Hospitals included 255 STEMI patients underwent PCI for STEMI from June 2024 till March 2025. The CHA2DS2-VASc-HSF-TT score was calculated, incorporating factors like thrombolysis usage and PCI delay and was correlated to no-reflow. In-hospital outcomes like mortality, heart failure and arrhythmias were assessed. Results: 22.35% of patients experienced no-reflow. Statistically significant associations with no-reflow included heart failure (P = 0.0159), diabetes (P = 0.0007), hypertension (P < 0.0001) and delayed PCI (>6 hours) (P < 0.0001). The CHA2DS2-VASc-HSF-TT score had an AUC of 0.846, with 82.5% sensitivity, 79.3% specificity, and 80% accuracy. PCI delay >6 hours was a strong predictor for no-reflow (AUC 0.955). Conclusion: The CHA2DS2-VASc-HSF-TT score is a strong predictor of no-reflow in STEMI patients (cutoff ≥5). Delayed PCI (>6 hours) is an important independent predictor, emphasizing the need for timely intervention or bridging thrombolysis to improve outcomes. | ||
| Keywords | ||
| CHA2DS2-VASc-HSF-TT score; No-reflow; STEMI; PCI | ||
|
Statistics Article View: 18,053 PDF Download: 101 |
||
