Document Type : Original Article
Authors
1
Assistant Professor of Cardiology, Faculty of medicine, Zagazig university
2
Cardiology Department, Faculty of Medicine, Zagazig University
3
cardiovascular ,faculty of medicine,zagazig university ,sharkia,cairo
4
Cardiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
5
Cardiology 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.
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