Predictive value of the Novel CHA2DS2-VASc-HSF-TT Score for No-reflow in Patients Undergoing Primary and Post-thrombolysis Percutaneous Coronary Intervention
Ghanem, I., Samy, M., Kandeel, N., Fotouh, K., Abomandour, H. (2025). Predictive value of the Novel CHA2DS2-VASc-HSF-TT Score for No-reflow in Patients Undergoing Primary and Post-thrombolysis Percutaneous Coronary Intervention. EKB Journal Management System, 31(6), 2483-2493. doi: 10.21608/zumj.2025.376659.3912
Islam Ghanem; Mohamed Samy; Nader Talat Kandeel; Khaled Fotouh Fotouh; Hala Gouda Abomandour. "Predictive value of the Novel CHA2DS2-VASc-HSF-TT Score for No-reflow in Patients Undergoing Primary and Post-thrombolysis Percutaneous Coronary Intervention". EKB Journal Management System, 31, 6, 2025, 2483-2493. doi: 10.21608/zumj.2025.376659.3912
Ghanem, I., Samy, M., Kandeel, N., Fotouh, K., Abomandour, H. (2025). 'Predictive value of the Novel CHA2DS2-VASc-HSF-TT Score for No-reflow in Patients Undergoing Primary and Post-thrombolysis Percutaneous Coronary Intervention', EKB Journal Management System, 31(6), pp. 2483-2493. doi: 10.21608/zumj.2025.376659.3912
Ghanem, I., Samy, M., Kandeel, N., Fotouh, K., Abomandour, H. Predictive value of the Novel CHA2DS2-VASc-HSF-TT Score for No-reflow in Patients Undergoing Primary and Post-thrombolysis Percutaneous Coronary Intervention. EKB Journal Management System, 2025; 31(6): 2483-2493. doi: 10.21608/zumj.2025.376659.3912

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, Page 2483-2493  XML PDF (1.02 MB)
Document Type: Original Article
DOI: 10.21608/zumj.2025.376659.3912
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Authors
Islam Ghanemorcid 1; Mohamed Samy email orcid 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
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