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New CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction
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 singl...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382102/ https://www.ncbi.nlm.nih.gov/pubmed/32711475 http://dx.doi.org/10.1186/s12872-020-01623-w |
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author | Zhang, Qin-Yao Ma, Shu-Mei Sun, Jia-Ying |
author_facet | Zhang, Qin-Yao Ma, Shu-Mei Sun, Jia-Ying |
author_sort | Zhang, Qin-Yao |
collection | PubMed |
description | 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 CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-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 CHA(2)DS(2)-VASc-HSF score had a higher predictive value than the other two scores, and a CHA(2)DS(2)-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 CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HSF scores can all be used as simple tools to predict NRP, our findings show that the CHA(2)DS(2)-VASc-HSF score had the highest predictive value. Thus, the CHA(2)DS(2)-VASc-HSF score may be an optimal tool for predicting high-risk patients. |
format | Online Article Text |
id | pubmed-7382102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73821022020-07-27 New CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction Zhang, Qin-Yao Ma, Shu-Mei Sun, Jia-Ying BMC Cardiovasc Disord Research Article 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 CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-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 CHA(2)DS(2)-VASc-HSF score had a higher predictive value than the other two scores, and a CHA(2)DS(2)-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 CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HSF scores can all be used as simple tools to predict NRP, our findings show that the CHA(2)DS(2)-VASc-HSF score had the highest predictive value. Thus, the CHA(2)DS(2)-VASc-HSF score may be an optimal tool for predicting high-risk patients. BioMed Central 2020-07-25 /pmc/articles/PMC7382102/ /pubmed/32711475 http://dx.doi.org/10.1186/s12872-020-01623-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Zhang, Qin-Yao Ma, Shu-Mei Sun, Jia-Ying New CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
title | New CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
title_full | New CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
title_fullStr | New CHA(2)DS(2)-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 CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
title_short | New CHA(2)DS(2)-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction |
title_sort | new cha(2)ds(2)-vasc-hsf score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with st-segment elevation myocardial infarction |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382102/ https://www.ncbi.nlm.nih.gov/pubmed/32711475 http://dx.doi.org/10.1186/s12872-020-01623-w |
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