P1955The CHADS-VASc score is a predictor of No-Reflow in patients with NSTEMI

Abstract

Abstract Introduction No-reflow (NR) is one of the major complications associated with primary percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We aimed to elucidate the relationship between the CHA2DS2-VASc score and NR phenomena in patients with NSTEMI. Methods A total number of 428 consecutive patients with NSTEMI were assessed for this study. Patients were divided into 2 groups, those with NR, NR(+) (n=84), and those without NR, NR(−) (n=307), according to their post-PCI, no-reflow status. The thrombus burden was classified according to the TIMI thrombus grade (TTG). CHA2DS2-VASc scores were calculated for all patients. Results The CHA2DS2-VASc score was significantly higher in the NR(+) group compared to the NR(−) (3.48±1.19 vs 1.81±0.82, p<0.001). After a multivariate regression analysis, a higher CHA2DS2-VASc score (OR: 6.52, 95% CI: 3.51–12.14, p<0.001), hs-Troponin (OR: 1.077, 95% CI: 1.056–1.099, p<0.001) and TTG (OR: 1.563, 95% CI: 1.134–2.154, p=0.006) were independent predictors of NR. In-hospital mortality rates were significantly higher in the NR(+) group compared to the NR(−) (15% vs. 5%, p<0.001). Table 1. Demographic, clinical, and angiographic characteristic of the patients Variables NR(−) (n=307) NR(+) (n=84) p Age, years, mean ± SD 55.50±8.95 56.67±8.80 0.248 Female gender, n (%) 83 (%27) 25 (%30) 0.536 CHF, n (%) 30 (%10) 17 (%20) 0.019 HT, n (%) 116 (%38) 45 (%54) 0.004 DM, n (%) 67 (%22) 30 (%36) 0.009 Previous stroke/TIA, n (%) 9 (%3) 9 (%11) <0.001 CHA2DS2-VASc score, mean ± SD 1.81±0.82 3.48±1.19 <0.001 LVEF (%), mean ± SD 56.11±9.31 51.15±11.32 <0.001 hs-troponin (pg/ml) (NRI <14pg/ml) 56.59±11.83 114.23±26.42 <0.001 Serum creatinine, mean ± SD, mg/dl 0.89±0.13 0.91±0.22 0.852 Hemoglobin (g/dl) 14.16±1.76 14.10±1.74 0.782 TTG, median 1 (0–3) 3 (1–5) <0.001 TTG(4,5), n (%) 70 (%23) 36 (%42) <0.001 In-hospital mortality, n (%) 16 (%5) 13 (%15) <0.001 Conclusions In conclusion, CHA2DS2-VASc score is associated with higher risk of no-reflow in patients with NSTEMI undergoing PCI. Acknowledgement/Funding None