The ATRIA and Modified-ATRIA Scores in Evaluating the Risk of No-Reflow in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention

Abstract

The no-reflow (NR) phenomenon is frequently encountered in acute coronary syndrome. We evaluated the association between anticoagulation and risk factors in atrial fibrillation (ATRIA) and modified ATRIA risk scores and NR in ST-elevation myocardial infarction (STEMI). Consecutive patients (n = 551) who underwent primary percutaneous coronary intervention between December 2019 and June 2020 due to STEMI were included. The mean age of the patients was 60.5 ± 10.8 years (n = 369, 67% male). The ATRIA and modified anticoagulation and risk factors in atrial fibrillation-hyperlipidemia, smoking, male (m-ATRIA-HS) scores were calculated. The NR group had higher frequency of diabetes mellitus (DM), serum creatine kinase-MB (CK-MB) levels, and corrected thrombolysis in myocardial infarction frame count (cTFC) ( P = .002, P = .006, and P < .001, respectively). In regression analysis, ATRIA, m-ATRIA-HS, thrombus grade, and cTFC were independent predictors of NR. Age, higher CK-MB, and neutrophil-to-lymphocyte ratio and DM were the other predictors for NR. Pairwise comparison of receiver operating characteristics curve analysis showed that the m-ATRIA-HS (>2, area under curve [AUC]: 0.715) has better performance than ATRIA score (>1, AUC: 0.656), with a P < .022 and z statistics 2.279. In conclusion, ATRIA, especially the m-ATRIA-HS, can be used to evaluate NR risk in STEMI.

The Relationship of Coronary Thrombus Burden and Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Score in Patients With ST-Segment Elevation Myocardial Infarction

“…Çetinkal et al 11 suggested that the ATRIA score can predict long-term adverse events in myocardial infarction patients and prognostic assessment can be made with the ATRIA score. Abacıoğlu et al 13 have shown that the ATRIA score may predict no-reflow in patients undergoing primary PCI and may be associated with microvascular dysfunction. Another recent study suggested that the ATRIA score might be useful in predicting contrast-induced nephropathy (CIN) in STEMI patients who underwent primary PCI and that patients at high risk for CIN could be detected by using the ATRIA score in these patients.…”

“…Recent studies have shown that the ATRIA risk score is associated with adverse clinical outcomes in patients with acute coronary syndrome (ACS). 11 – 13 …”

Impact of HAT2CH2 Score on the Development of No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction

“…[26][27][28] Previous research has also demonstrated the NR connection of another risk score, ATRIA (the Anticoagulation and Risk Factors in Atrial Fibrillation), and its modified versions. 29 The HAT 2 CH 2 score, based on the patient's age and the presence of HT, stroke or transient ischemic attack, COPD, and HF, was developed in 2010 to identify patients likely to progress to sustained forms of AF. 10 The HAT 2 CH 2 score, in other words, is a scoring system that intends to demonstrate the development of chronic disease and advanced age-related risk factors to new AF without relying on laboratory results.…”

Comparing two risk scores for predictive ability of contrast-induced nephropathy development in patients presenting with chronic coronary syndrome

“…These two risk scores mainly consist of patient-related risk factors. Since CCS patients were included in the present stu- Although these risk scores were designed primarily to predict thrombo-embolism in AF, they were used in different cardiac conditions regardless of being in AF rhythm [16,[31][32][33][34]. CHA 2 DS 2 -VASc was found to have effective discriminating power in determining CIN development in STEMI patients [35].…”