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Document Type

Original Article

Abstract

Background: During primary PCI, about 95% of blocked coronary vessels are reopened. Therefore, it is the best applicable reperfusion strategy for acute STEMI.

Study aim: The objective was to investigate the significance of the RCHA2DS2-VASc score and CHA2DS2-VASc score in predicting the no-reflow phenomenon in STEMI patients undergoing Primary PCI.

Patients and Methods: In this cohort study, 80 patients with acute STEMI who undergone Primary PCI (40 patients had no-reflow and 40 patients without no-reflow) who were admitted to the coronary care units of October 6 University Hospital and Al-Azhar University Hospitals between September 2021 and March 2022 were included .

Results: As regard their comorbid conditions; renal failure was far more common with a statistical significance in patients who suffered from no-reflow. As regard the RCHA2DS2-VASc score as well as the CHA2DS2-VASc score, they have been significantly more in patients who suffered from no-reflow. Regarding the Receiver Operating Characteristic (ROC) curve, the cutoff point for the RCHA2DS2-VASc and CHA2DS2-VASc scores for prediction of the no-reflow phenomenon was found to be > 2 with an area under curve (AUC) 0.683 and 0.654, along with a sensitivity of 52.5% and 47.5%, respectively, accompanied by a specificity of 80% and a positive predictive value of 72.4 and 70.4, together with a negative predictive value of 62.7 and 60.4, respectively.

Conclusion: From this study we can conclude that RCHA2DS2-VASc score could predict no-reflow better than CHA2DS2- VASc score. In addition, those who had renal impairment were more liable to no-reflow phenomenon.

Keywords

RCHA2DS2-VASc, CHA2DS2-VASc, No-Reflow Phenomenon, STEMI, primary PCI

Subject Area

Cardiology

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