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Submitted: 10 Jan 2022
Revision: 29 Apr 2022
Accepted: 29 Apr 2022
ePublished: 25 Jun 2022
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J Cardiovasc Thorac Res. 2022;14(2): 122-127.
doi: 10.34172/jcvtr.2022.19
PMID: 35935384
PMCID: PMC9339737
Scopus ID: 85140840205
  Abstract View: 584
  PDF Download: 306
  Full Text View: 38

Original Article

CHA2 DS2 -VASc score, a simple clinical tool for early prediction of no-reflow phenomenon in patients undergoing emergency percutaneous coronary revascularization

Abdul Hakeem Shaikh 1 ORCID logo, Rajesh Kumar 1* ORCID logo, Ali Ammar 1, Afzal Hussain 1, Muhammad Naeem Mengal 1, Kamran Ahmed Khan 1, Danish Qayyum 1, Jawaid Akbar Sial 1, Tahir Saghir 1, Musa Karim 1

1 National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
*Corresponding Author: Corresponding Author: Rajesh Kumar, Email: , Email: rajeshnarsoolal@gmail.com

Abstract

Introduction: Slow flow/no reflow (SF/NR) phenomenon during emergency percutaneous revascularization is a feared complication associated with increased risk of adverse outcomes. CHA2 DS2 -VASc score has been proposed for the risk stratification but a very limited evidences are available regarding the accuracy of this system. Therefore, we conducted this study to assess the predictive value of CHA2 DS2 -VASc score for predicting SF/NR phenomenon during primary percutaneous coronary intervention (PCI).

Methods: This analytical cross-sectional study included 596 consecutive patients undergoing PCI for STEMI at a tertiary care cardiac center of Karachi, Pakistan. Baseline -VASc sore was calculated and development of SF/NR phenomenon during primary PCI was recorded. Predictive value of the score was assessed through area under the curve (AUC) of receiver operating characteristic curve analysis and sensitivity and specificity were computed. Logistic regression analysis was performed to assess the predictive strength of the score.

Results: A total of 596 patients were included, mean age was 56.28±11.44 years, and 75.7%(451) were male. The slow/no reflow phenomenon during the procedure was observed in 36.6%(218) of the patients. CHA2 DS2 -VASc≥2 was observed in 50.2%(299) of the patients. The CHA2 DS2 -VASc score was significantly higher in SF/NR patients, 2.06±1.25 vs. 1.37±1.33; P<0.001. The AUC of CHA2 DS2 -VASc score was 0.652 [0.607-0.696], CHA2 DS2 -VASc≥2 had sensitivity and specificity of 65.6% [58.9% to 71.9%] and 58.3% [53.6% to 63.7%] respectively for predicting SF/NR. CHA2 DS2 -VASc≥2 was insignificant on multivariate with odds ratio of 1.48 [0.72 -3.04]; P=0.283.

Conclusion: CHA2 DS2 -VASc risk stratification system has moderate discriminating power for the stratification of SF/NR phenomenon during primary PCI.

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