New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction
Abstract Background The no-reflow phenomenon (NRP) is a serious complication of primary percutaneous coronary intervention (PPCI) and is an independent predictor of poor prognosis. We aimed to find a simple but effective risk stratification method for the prediction of NRP. Methods This retrospectiv...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12872-020-01623-w |
| _version_ | 1818891905082064896 |
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| author | Qin-Yao Zhang Shu-Mei Ma Jia-Ying Sun |
| author_facet | Qin-Yao Zhang Shu-Mei Ma Jia-Ying Sun |
| author_sort | Qin-Yao Zhang |
| collection | DOAJ |
| description | Abstract Background The no-reflow phenomenon (NRP) is a serious complication of primary percutaneous coronary intervention (PPCI) and is an independent predictor of poor prognosis. We aimed to find a simple but effective risk stratification method for the prediction of NRP. Methods This retrospective single-center study included 454 consecutive patients diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and treated by PPCI, who were admitted to our emergency department between January 2017 and March 2019. The patients were divided according to the post-PPCI thrombolysis in the myocardial infarction flow rate: the NRP group and the control group. The CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores were calculated for all the patients in this study, and multivariable regression and receiver operating characteristic curve analyses were conducted to determine the independent predictors of NRP and the predictive value of the three scores. Results A total of 454 patients were analyzed in this study: 80 in the no-reflow group and 374 in the control group. The incidence of NRP was 17.6%. Creatine kinase-myocardial band, Killip class, stent length, and multivessel disease also independently predicted NRP. The CHA2DS2-VASc-HSF score had a higher predictive value than the other two scores, and a CHA2DS2-VASc-HSF score of ≥4 predicted NRP with a sensitivity of 72.5% and specificity of 66.5% (area under the curve: 0.755, 95% confidence interval [0.702–0.808]). Conclusion Although the CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores can all be used as simple tools to predict NRP, our findings show that the CHA2DS2-VASc-HSF score had the highest predictive value. Thus, the CHA2DS2-VASc-HSF score may be an optimal tool for predicting high-risk patients. |
| first_indexed | 2024-12-19T17:48:14Z |
| format | Article |
| id | doaj.art-bd6245ead544462ca2647b270017b511 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-19T17:48:14Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-bd6245ead544462ca2647b270017b5112022-12-21T20:12:00ZengBMCBMC Cardiovascular Disorders1471-22612020-07-012011910.1186/s12872-020-01623-wNew CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarctionQin-Yao Zhang0Shu-Mei Ma1Jia-Ying Sun2Department of Cardiology, Shengjing Hospital of China Medical UniversityDepartment of Cardiology, Shengjing Hospital of China Medical UniversityDepartment of Cardiology, Shengjing Hospital of China Medical UniversityAbstract Background The no-reflow phenomenon (NRP) is a serious complication of primary percutaneous coronary intervention (PPCI) and is an independent predictor of poor prognosis. We aimed to find a simple but effective risk stratification method for the prediction of NRP. Methods This retrospective single-center study included 454 consecutive patients diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and treated by PPCI, who were admitted to our emergency department between January 2017 and March 2019. The patients were divided according to the post-PPCI thrombolysis in the myocardial infarction flow rate: the NRP group and the control group. The CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores were calculated for all the patients in this study, and multivariable regression and receiver operating characteristic curve analyses were conducted to determine the independent predictors of NRP and the predictive value of the three scores. Results A total of 454 patients were analyzed in this study: 80 in the no-reflow group and 374 in the control group. The incidence of NRP was 17.6%. Creatine kinase-myocardial band, Killip class, stent length, and multivessel disease also independently predicted NRP. The CHA2DS2-VASc-HSF score had a higher predictive value than the other two scores, and a CHA2DS2-VASc-HSF score of ≥4 predicted NRP with a sensitivity of 72.5% and specificity of 66.5% (area under the curve: 0.755, 95% confidence interval [0.702–0.808]). Conclusion Although the CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores can all be used as simple tools to predict NRP, our findings show that the CHA2DS2-VASc-HSF score had the highest predictive value. Thus, the CHA2DS2-VASc-HSF score may be an optimal tool for predicting high-risk patients.http://link.springer.com/article/10.1186/s12872-020-01623-wCHA2DS2-VASc-HSF scoreST-segment elevation myocardial infarctionPrimary percutaneous coronary interventionNo-reflow phenomenon |
| spellingShingle | Qin-Yao Zhang Shu-Mei Ma Jia-Ying Sun New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction BMC Cardiovascular Disorders CHA2DS2-VASc-HSF score ST-segment elevation myocardial infarction Primary percutaneous coronary intervention No-reflow phenomenon |
| title | New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
| title_full | New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
| title_fullStr | New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
| title_full_unstemmed | New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
| title_short | New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
| title_sort | new cha2ds2 vasc hsf score predicts the no reflow phenomenon after primary percutaneous coronary intervention in patients with st segment elevation myocardial infarction |
| topic | CHA2DS2-VASc-HSF score ST-segment elevation myocardial infarction Primary percutaneous coronary intervention No-reflow phenomenon |
| url | http://link.springer.com/article/10.1186/s12872-020-01623-w |
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