Comparison of RCHA2DS2-VASc score and CHA2DS2-VASc score prediction of no-reflow phenomenon in patients with ST-segment elevation myocardial infarction

OBJECTIVE
No-reflow is a phenomenon that can arise due to factors such as distal embolization, microvascular occlusion, or prolonged myocardial ischemia and damage. It occurs in about 5% to 10% of patients after primary percutaneous coronary intervention. The CHA2DS2-VASc score can be easily calculated in daily practice and the components of this score are similar to common risk factors for no-reflow. Chronic renal disease generates a hypercoagulable state, which is associated with increased risk of no-reflow in cases of ST-segment elevation myocardial infarction (STEMI). A modified CHA2DS2-VASc score has been developed to include patients with renal dysfunction. The aim of this study was to investigate the prognostic significance of this scoring system, the RCHA2DS2-VASc score, in patients with no-reflow.

METHODS
A total of 75 patients with no-reflow and 1138 patients without no-reflow after STEMI were retrospectively enrolled in this study. The CHA2DS2-VASc and RCHA2DS2-VASc scores of the two groups were compared.

RESULTS
The median CHA2DS2-VASc score and the median RCHA2DS2-VASc score were significantly higher in the no-reflow group (p<.001, for both). There was a statistically significant difference between the groups in all of the components of the CHA2DS2-VASc score. An RCHA2DS2-VASc score of ≥2 was a predictor of no-reflow with a sensitivity of 83% and specificity of 62%.

CONCLUSION
The RCHA2DS2-VASc score is a simple, inexpensive, and easily accessible score to predict no-reflow.