Predictive accuracy of CHA2DS2-VASc score in determining the high thrombus burden in patients with non-ST-elevation myocardial infarction

Abstract

Background The presence of intracoronary thrombus is associated with increased ischaemic complications in patients with NSTEMI. High thrombus burden is an independent predictor of major adverse cardiovascular events, stent thrombosis and no reflow in patients with STEMI. CHA2DS2-VASc score predicts thrombus burden in STEMI patients undergoing primary percutaneous coronary intervention. However, the association between CHA2DS2-VASc score and high thrombus burden in patients with NSTEMI is unknown. The purpose of this study was to evaluate the predictive value of CHA2DS2-VASc score for a high pre-procedural intracoronary thrombus burden in patients with NSTEMI who underwent PCI. Methods We performed a retrospective analysis of 251 patients with NSTEMI who underwent PCI during their hospitalisation at our tertiary referral centre. Results The mean age of the 251 patients was 57.7 ± 10.9 years. Our patients were predominantly male (79%). There were 57 patients (22.7%) in the high-thrombus burden group, and 194 patients (77.2%) in the low-thrombus burden group. Higher CHA2DS2-VASc score, increased baseline serum CRP level, lower serum albumin level and decreased lymphocyte counts were found to be independently correlated with the high intracoronary thrombus burden in multivariate Cox regression analysis. Receiver-operating characteristics analysis revealed the cut-off value of CHA2DS2-VASc score >2 as a predictor of high thrombus burden with a sensitivity of 74% and a specificity of 61%. Conclusions CHA2DS2-VASc score can be used as a simple and reliable tool to predict high thrombus burden in NSTEMI patients undergoing PCI.