article · QJM
No-reflow is a complication that causes severe outcomes such as heart failure, stroke, and death in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. This prospective observational study evaluated 300 patients at Ain Shams University to determine whether the CHA2DS2-VASc score, typically used to evaluate thromboembolic risk in atrial fibrillation, can predict no-reflow. Within the score items, female sex and diabetes mellitus were the most frequent factors. Although individual items within the score were significantly more frequent in no-reflow cases, except for age 75 and older, the overall CHA2DS2-VASc score demonstrated low diagnostic performance for predicting no-reflow in this Egyptian population. Additionally, a postulated modification of the score slightly improved on the original but still failed to provide high diagnostic performance.
When treating severe heart attacks with artery-opening procedures, blood flow sometimes fails to return to the heart tissue properly, leading to major health risks. Evaluating whether existing clinical scoring tools can identify patients at risk helps doctors understand the limitations of these metrics and highlights where new or refined diagnostic approaches are needed.
The findings inform clinical decision-support developers and cardiologists regarding the utility of standard risk scores for predicting procedural complications. Because both the original and modified scoring systems demonstrated low diagnostic performance, this work represents early-stage clinical assessment showing that existing tools require substantial refinement before they can be effectively deployed in clinical risk-prediction software.
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Abstract Background regardless of the magnitude of the infarction, no-reflow is a source of numerous problems, including heart failure, stroke, and death. The CHA2DS2-VASc score is a combination of many risk variables for thromboembolic lesions, the most serious consequences of atrial fibrillation. Current guidelines propose using the CHA2DS2-VASc risk score to estimate thromboembolic events in individuals with atrial fibrillation. It has been demonstrated to be a predictor of problems following acute coronary crises. Aim of the Work to assess the role of CHA2DS2-VASc score in prediction of the no-reflow among patients with ST-segment elevation myocardial infarction (STEMI) who was treated with primary PCI. Subjects and Methods this is a prospective observational study which was done at cardiology department of Ain Shams University on 300 patients. Results the most frequent factor was female sex (43.7%), followed by Diabetes mellitus (27.0%) according to CHA2DS2-VASc score. CHA2DS2-VASc score items statistically were significantly more frequent in no reflow cases except Age ≥75. CHA2DS2-VASc score and its modification significantly had low diagnostic performance in predicting no reflow. Modified was higher than original. Conclusion all CHA2DS2-VASC items were proved to be factors affecting no reflow occurrence in the Egyptian population except Age ≥75 and congestive heart failure due to their low prevalence. The CHA2DS2-VASC score had no high diagnostic characteristics in Egyptian population, the postulated modification of CHA2DS2-VASC score gave no better diagnostic characteristics.
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DOI: 10.1093/qjmed/hcae070.118
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