EVALUATION OF CHA₂DS₂-VASC SCORE TO PREDICT NO REFLOW PHENOMENON IN PATIENTS WITH ST ELEVATED MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective:
To evaluate the prognostic efficacy of the CHA₂DS₂-VASc scoring system in predicting the incidence of the no reflow phenomenon in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who are receiving primary percutaneous coronary intervention (PPCI).
Methodology:
The study was a prospective observational analytical study conducted in the Department of Cardiology, National Institute of Cardiovascular Diseases, Karachi. It involved 124 patients between the age of 18 and 70 years with STEMI and treated with PPCI. The CHA₂DS₂-VASc score was assessed pre-procedure and angiographic evaluation revealed no-reflow when the post-intervention TIMI flow was less than grade III. Statistical analysis has been done on SPSS v26 by implementing ROC curve and Chi-square analysis with
significance level of p < 0.05.
Results:
Among a study group of 124 participants (mean age 55.8 ± 9.6 years; 81.5% male and 18.5% female), 22.6% demonstrated the occurrence of the no-reflow phenomenon subsequent to (PPCI). Patients with no-reflow had significantly higher CHA₂DS₂-VASc scores compared to those with reflow (3.60±1.49 vs.2.18±1.12; p<0.001). Smoking showed a significant relationship with no-reflow. Receiver operating characteristic analysis demonstrated good predictive ability for the CHA₂DS₂-VASc score (AUC=0.765,95%CI: 0.670–0.860; p < 0.001).
Conclusion:
The present study indicates that the CHA₂DS₂-VASc score serves as a useful clinical tool for anticipating the likelihood of no-reflow among individuals presenting with STEMI treated through PPCI. Elevated scores were associated with a greater probability of no-reflow, particularly in female and smoking patients, supporting its role in guiding early clinical decision-making.
Keywords:
CHA₂DS₂-VASc score, No-reflow phenomenon, Percutaneous coronary intervention, ST-elevation myocardial infarction