CHA2DS2-VASc score as a predictor of no-reflow phenomenon after saphenous vein graft percutaneous coronary intervention in patients with non–ST-segment elevation acute coronary syndromes

Gürbak, İsmail; Panç, Cafer; Şahin, Ahmet Anıl; Derviş, Emir; Yıldız, İbrahim; Güler, Arda; Demir, Ali; Kahraman, Serkan; Uzun, Fatih

doi:10.33963/kp.15603

Cited by 9 publications

(5 citation statements)

References 28 publications

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“…This is in harmony with Mirbolouk et al (10) who reported that, the mean CHA2DS2-VASc score was 1.6 ± 1.4 and it was significantly higher in the no-reflow group compared to the control group (3 ± 1.4 versus 1.1 ± 1.1, P < 0.001). This also agreed with Gürbak et al (17) who aimed to investigate the relationship between the CHA2DS2-VASc score and no-reflow phenomenon after SVG PCI in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). They reported that the CHA2DS2-VASc score (P <0.001) was significantly higher in no-reflow group.…”

Section: Discussionsupporting

confidence: 88%

“…Furthermore, Zhang et al ( 14) demonstrated that the CHADS2, CHA2DS2-VASc, score was independent predictor of NRP after PPCI in patients with STEMI. In addition, Gürbak et al (17) reported that, receiver operating characteristics analysis showed that a CHA2DS2-VASc score of 4 predicted no-reflow phenomenon with 67.9% sensitivity and 69.3% specificity.…”

Section: Discussionmentioning

confidence: 99%

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CHA2DS2 - Vasc Score Predict No Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Eldarky¹,

Elkeshk²,

Elnager³

et al. 2023

AJHMN

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Purpose: ST-Elevation Myocardial Infarction is the most acute manifestation of Coronary artery disease, with substantial morbidity and mortality. Early reperfusion (re-establishing the blood flow in the occluded artery) is the most effective way to preserve the viability of the ischaemic myocardium and limit infarct size. Early diagnosis of STEMI is crucial to initiate appropriate treatment and should ideally be made within 10 minutes of first medical contact. This study aimed to evaluate the CHA2DS2-VASc score as a simple tool for predicting the no-reflow among patients with STEMI who underwent primary percutaneous coronary intervention. Methodology: This was a case-control study which was conducted on 100 patients, diagnosed with acute STEMI and underwent primary PCI, who was admitted to Cardiology Department, Benha University Hospital and National Heart Institute. Patients were classified into two groups, control and no-flow, according to their final angiographic TIMI flow rates resulting from primary PCI. The control group: 78 patients with TIMI flow rate >2. The no-reflow group: 22 patients with TIMI flow rate ≤2, despite mechanical reopening of the infarct-related artery in patients without dissection of the coronary artery. Findings: In this study, LVEF was significantly lower in patients with no-reflow compared to patients with normal TIMI flow (p <0.001), but LVEDV was significantly higher (p =0.01). There was no significant difference in LVESV between patients with no-reflow compared to patients with normal TIMI flow. CHA2DS2VASC score was significantly higher in patients with no-reflow compared to patients with normal TIMI flow (p <0.001). CHA2DS2VASC score is a significant predictor of occurrence of no reflow phenomenon (AUC: 0.689, p =0.006). At a cut off value of ≥ 2it has a sensitivity of 68.2%, specificity of 58.9%, PPV of 31.9% and NPV of 86.8%. Recommendation: The study suggest that the CHA2DS2‑VASc score can be an independent predictor of no‑reflow phenomenon in patients undergoing primary PCI. As a simple and easy‑to‑calculate score, it might be a useful assessment tool to predict no‑reflow phenomenon before primary PCI interventions in patients with STEMI. Thus we recommend using CHA2DS2-VASc score as it is very simple and a quick tool to predict no-reflow before primary PCI

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

CHA2DS2 - Vasc Score Predict No Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Eldarky¹,

Elkeshk²,

Elnager³

et al. 2023

AJHMN

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“…3 CHA 2 DS 2 and CHA 2 DS 2 -VASc score models are widely used to predict the risk of subsequent thromboembolic events in patients with atrial fibrillation (AF) and include similar risk factors for the development of CAD. 4,5 Recent evidence has shown that the CHADS 2 score has prognostic ability in CAD, 6,7 regardless of the presence of AF, 8 and has suggested the power of CHADS 2 and CHA 2 DS 2 -VA to assess major adverse cardiovascular outcomes in the setting of ACS. 9 Moreover, a retrospective study found that the CHA 2 DS 2 -VASc score was associated with a higher risk of in-hospital mortality rates in patients who underwent primary percutaneous coronary intervention (PCI) for STEMI.…”

mentioning

confidence: 99%

Predictive Value of CHA₂DS₂ -VASc-HSF Score for Severity of Acute Coronary Syndrome

Liu

et al. 2022

Clin Appl Thromb Hemost

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CHADS2 and CHA2DS2-VASc scores have been used to assess the prognostic risk of thromboembolism in non-valvular atrial fibrillation patients. Recent studies have shown the utility of CHADS2 and CHA2DS2-VASc scores for evaluating the severity of coronary artery disease (CAD). The newly defined CHA2DS2-VASc-HSF score evaluates atherosclerosis and is associated with CAD severity. This study investigated the association between the CHA2DS2-VASc-HSF score and acute coronary syndrome (ACS) severity as assessed by the Gensini score and the number of vessels. Furthermore, this study also compared the diagnostic value of the CHADS2, CHA2 DS2-VASc, and CHA2DS2-VASc-HSF score for ACS. A total of 2367 eligible inpatients (ACS group [ n = 2030]; non-CAD group [ n = 337]) were consecutively enrolled in this study. Receiver operating characteristic curve diagnostic tests and logistic regression models were used to analyze the risk factors for ACS. The CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores were significantly higher in the ACS group than those in the control group. After adjusting for numerous traditional CAD risk factors, an increased CHA2DS2-VASc-HSF score was found to be an independent risk factor for patients with ACS (odds ratio 1.401, 95% confidence interval 1.044, −1.879; P < 0.05). A newly diagnosed CHA2DS2-VASc-HSF score predicts the severity of ACS.

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“…Both ACS and SVG interventions are risk factors for the development of no-reflow [ 24 ]. In Gürbak et al ’s study, the rate of no-reflow development was 29% in interventions performed in the SVG [ 25 ]. In another study, this rate was 18% in patients undergoing PCI of the SVG [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of the systemic immune–inflammatory index on the no-reflow phenomenon in patients undergoing saphenous vein intervention

Cakmak,

Kocayigit,

Varım

et al. 2024

pwki

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Introduction The systemic immune inflammation index (SII), based on lymphocyte, neutrophil, and platelet counts, has been shown to be an independent indicator of no-reflow phenomenon during percutaneous intervention. However, the relationship between SII and no-reflow phenomenon (NRP) that develops after the procedure of saphenous vein grafts is unknown. Aim In this study, we aimed to investigate the relationship between no-reflow phenomenon and SII during percutaneous intervention on saphenous vein grafts. Material and methods A total of 133 patients who underwent percutaneous intervention for saphenous vein grafts due to acute coronary syndrome between 2019 and 2022 were included in this study. The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of SII to predict the no-reflow. The multivariate regression was used to analyse the correlation between no-reflow and SII. Results The median value of SII was significantly higher in patients with no-reflow in comparison with normal reperfusion (543 (447, 717) vs. 861 (642, 1272), p < 0.001). The optimal threshold for SII in predicting the no-reflow phenomenon was 613, with sensitivity and specificity of 84% and 66%, respectively. The area under the ROC curve (AUC) was 0.80 (95% CI: 0.73–0.89, p < 0.001). In multivariate analysis, SII ≥ 613 showed an independent predictive value for the no-reflow (OR = 4.02, 95% CI: 1.40–11.57, p < 0.001). Conclusions Our results showed that high SII levels were independently associated with the development of no-reflow phenomenon in patients presenting with acute coronary syndrome and undergoing percutaneous intervention to the SVG.

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CHA2DS2-VASc score as a predictor of no-reflow phenomenon after saphenous vein graft percutaneous coronary intervention in patients with non–ST-segment elevation acute coronary syndromes

Cited by 9 publications

References 28 publications

CHA2DS2 - Vasc Score Predict No Reflow Phenomenon in Primary Percutaneous Coronary Intervention

CHA2DS2 - Vasc Score Predict No Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Predictive Value of CHA₂DS₂ -VASc-HSF Score for Severity of Acute Coronary Syndrome

The effect of the systemic immune–inflammatory index on the no-reflow phenomenon in patients undergoing saphenous vein intervention

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CHA2DS2-VASc score as a predictor of no-reflow phenomenon after saphenous vein graft percutaneous coronary intervention in patients with non–ST-segment elevation acute coronary syndromes

Cited by 9 publications

References 28 publications

CHA2DS2 - Vasc Score Predict No Reflow Phenomenon in Primary Percutaneous Coronary Intervention

CHA2DS2 - Vasc Score Predict No Reflow Phenomenon in Primary Percutaneous Coronary Intervention

Predictive Value of CHA2DS2 -VASc-HSF Score for Severity of Acute Coronary Syndrome

The effect of the systemic immune–inflammatory index on the no-reflow phenomenon in patients undergoing saphenous vein intervention

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Product

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Predictive Value of CHA₂DS₂ -VASc-HSF Score for Severity of Acute Coronary Syndrome