Predictive accuracy of CHA₂DS₂-VASc score in determining the high thrombus burden in patients with non-ST-elevation myocardial infarction

Abstract

Background

The presence of intracoronary thrombus is associated with increased ischaemic complications in patients with NSTEMI. High thrombus burden is an independent predictor of major adverse cardiovascular events, stent thrombosis and no reflow in patients with STEMI. CHA₂DS₂-VASc score predicts thrombus burden in STEMI patients undergoing primary percutaneous coronary intervention. However, the association between CHA₂DS₂-VASc score and high thrombus burden in patients with NSTEMI is unknown. The purpose of this study was to evaluate the predictive value of CHA₂DS₂-VASc score for a high pre-procedural intracoronary thrombus burden in patients with NSTEMI who underwent PCI.

Methods

We performed a retrospective analysis of 251 patients with NSTEMI who underwent PCI during their hospitalisation at our tertiary referral centre.

Results

The mean age of the 251 patients was 57.7 ± 10.9 years. Our patients were predominantly male (79%). There were 57 patients (22.7%) in the high-thrombus burden group, and 194 patients (77.2%) in the low-thrombus burden group. Higher CHA₂DS₂-VASc score, increased baseline serum CRP level, lower serum albumin level and decreased lymphocyte counts were found to be independently correlated with the high intracoronary thrombus burden in multivariate Cox regression analysis. Receiver-operating characteristics analysis revealed the cut-off value of CHA2DS2-VASc score >2 as a predictor of high thrombus burden with a sensitivity of 74% and a specificity of 61%.

Conclusions

CHA₂DS₂-VASc score can be used as a simple and reliable tool to predict high thrombus burden in NSTEMI patients undergoing PCI.

Keywords:

• CHA₂DS₂-VASc score
• non-ST-elevation myocardial infarction
• thrombus burden
• serum albumin
• C-reactive protein

Ethical statement

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Disclosure statement

The authors did not report conflict of interest regarding this work. There is no financial relationship and this work was not supported by any company.