AUTHOR=Zhang Qinyao , Hu Meirong , Ma Shumei , Niu Tiesheng 

TITLE=New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.899739

DOI=10.3389/fcvm.2022.899739

ISSN=2297-055X

ABSTRACT=<sec><title>Aims</title><p>Evaluating the prognostic validity of new R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc score for no-reflow phenomena and long-term prognosis in patients following primary percutaneous coronary intervention (PCI) with ST-elevation myocardial infarction (STEMI).</p></sec><sec><title>Materials and methods</title><p>From January 2017 to December 2018, a total of 401 patients with STEMI were continuously enrolled. According to the cut-off value, the patients were separated into two groups: R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc &lt; 3 group (<italic>n</italic> = 275) and R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc ≥ 3 group (<italic>n</italic> = 126).</p></sec><sec><title>Results</title><p>With a sensitivity of 52.6% and a specificity of 73.1%, the optimal cut-off value for predicting no-reflow is R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc ≥ 3. R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc ≥ 3 as the ideal cut-off value for predicting major adverse cardiovascular events (MACE) with an area under the curve (AUC) of 0.781 [95% Confidence interval (CI): 0.738–0.801, <italic>P</italic> 0.001], a sensitivity of 50%, and a specificity of 91.1%. The incidence of MACE, death from all causes, and worsening heart failure was greater in the R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc ≥ 3 group, although there was no significant difference in the incidence of repeated revascularisation procedures following PCI between the two groups. R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc ≥ 3 was also an independent predictor of MACE (hazard ratio = 2.48, 95% confidence interval CI: 1.33–4.62, <italic>P</italic> = 0.04). Moreover, this score has a greater sensitivity (66.7%) and specificity (88.7%) for predicting the progression of heart failure.</p></sec><sec><title>Conclusion</title><p>R<sub>2</sub>-CHA<sub>2</sub>DS<sub>2</sub>-VASc ≥ 3 was independently associated with no-reflow phenomenon and poor clinical outcomes for patients in STEMI after primary PCI.</p></sec>