The CHADS-VASc score is a predictor of no-reflow in patients with non-ST-segment elevation myocardial infarction

Barman, Hasan Ali; Kahyaoğlu, Serdar; Durmaz, Eser; Atıcı, Adem; Gülşen, Kamil; Tuğrul, Sevil; Isleyen, Hasan Burak; Yıldırım, Mehmet Rıfat; Güngör, Barış; Okuyan, Ertuğrul; Şahin, İrfan

doi:10.1097/mca.0000000000000781

Cited by 23 publications

(19 citation statements)

References 32 publications

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“…30 It also predicts the development of acute stent thrombosis in patients with STEMI following a primary PCI, and no reflow in occluded vessels during ACS. 8,31 Çınar et al showed that the CHA2DS2-VASc score has a predictive value for the development of prosthetic valve thrombosis in patients with mechanical prosthetic valves regardless of the presence of AF. 32 Diabetes mellitus is associated with an increased prevalence and severity of CAD, increased incidence of ACS, and poor outcomes compared with patients without DM.…”

Section: Discussionmentioning

confidence: 99%

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The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction

et al. 2021

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Early detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 ± 2.32 vs 2.15 ± 1.79, P <.001). The Global Registry of Acute Coronary Events (GRACE) score ( P = .002) and the CHA2DS2-VASc score ( P < .001) were also found to be significant independent predictors for total occlusion in multiple regression analysis. A CHA2DS2-VASc score ≥3 had 68.1% sensitivity and 64.0% specificity (area under the curve (AUC): 0.657, 95% CI: 0.585-0.725, P < .001) for predicting TO. The CHA2DS2-VASc score was an effective tool that predicted TO in patients with NSTEMI.

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Section: Discussionmentioning

confidence: 99%

“…6,7 Recent publications have also shown that this score can predict the success of the procedure in patients with ST elevation myocardial infarction (STEMI). 8,9 The present study investigated the utility of the CHA2DS2-VASc risk score as a predictor of TO in patients with NSTEMI.…”

Section: Introductionmentioning

confidence: 99%

The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction

et al. 2021

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“…There are studies supporting the relationship between NR and the CHA 2 DS 2 -Vasc score, which is among these risk scores and is considered to be a prognostic marker for many cardiac conditions. 42–44 In another study, the new CHA 2 DS 2 -VASc-HSF score, which includes hyperlipidemia, smoking, and family history for coronary artery disease in addition to the classical score, was found to be an independent predictor of NR in patients with STEMI treated with pPCI. 17 The NR risk was increased in those with a score ≥2 in the study by İpek et al 45…”

Section: Discussionmentioning

confidence: 99%

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

Abacıoğlu¹,

Yıldırım²,

Koyunsever³

et al. 2021

Angiology

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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.

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“…The CHA2DS2‐VASc score is an easy‐to‐use, reproducible, and effective scoring system that predicts cardioembolic risk in patients with nonvalvular AF 5 . It predicts the development of no reflow in occluded vessels in acute coronary syndrome 10,11 . The pre‐admission CHA2DS2‐VASc score is associated with the 90‐day poor endpoint in ischemic stroke patients with AF 25,26 .…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that this score is associated with higher coronary thrombus burden in patients with acute coronary syndrome 9 . The score is also useful for predicting procedure success in patients with ST elevation myocardial infarction 10,11 …”

Section: Introductionmentioning

confidence: 99%

The CHA2DS2‐VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke

Yaşar

Akalin

Aktaş

et al. 2021

Acta Neuro Scandinavica

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Objectives Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2‐VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2‐VASC score in patients with acute ischemic stroke who underwent endovascular intervention. Materials and methods A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2‐VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2‐VASc score was evaluated. Results CHA2DS2‐VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 ± 1.44, 5.02 ± 1.77 p < .001). Receiver‐operating characteristics analysis revealed the cutoff value of CHA2DS2‐VASc score ≥3 as a predictor of unsuccessful intervention with 76,6% sensitivity and 83,3% specificity, positive predictive value 50%, negative predictive value 84,6% (area under the curve [AUC]: 0.827,95% CI: 0.739–0.895, p < .001). In the multivariate analysis; atrial fibrillation ([β] = 4.201; [CI]: 1.251–14.103, p = .020), CHA2DS2‐VASc score ([β] = 0.053; [CI]: 0.004–0.750, p = .030) were found independent predictors for unsuccessful intervention treatment. Conclusions In our study, we showed that the CHA2DS2‐VASc score is associated with the success of endovascular intervention in patients with acute ischemic stroke who underwent percutaneous endovascular treatment.

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The CHADS-VASc score is a predictor of no-reflow in patients with non-ST-segment elevation myocardial infarction

Cited by 23 publications

References 32 publications

The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction

The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction

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

The CHA2DS2‐VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke

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