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Presence of Microvascular Dysfunction and CHA2DS2-VASc Score in Patients with ST-Segment Myocardial Infarction after

Ragab A Mahfouz1, Marwa M Gad1, Mohamed Arab1

  • 1Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.

Pulse (Basel, Switzerland)
|January 27, 2022
PubMed

Insights

The CHA2DS2-VASc score can predict microvascular dysfunction (MVD) after ST-segment elevation myocardial infarction (STEMI) treatment. A higher score indicates increased MVD risk following primary percutaneous intervention (PPCI).

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Microvascular dysfunction (MVD) is a complication after primary percutaneous intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI).
  • Assessing MVD risk is crucial for optimizing patient outcomes.
  • The CHA2DS2-VASc score is a validated risk stratification tool in cardiovascular disease.

Purpose of the Study:

  • To investigate the relationship between the CHA2DS2-VASc score and microvascular resistance (IMR) in STEMI patients post-PPCI.
  • To determine if the CHA2DS2-VASc score can predict MVD, assessed by IMR, immediately after PPCI.

Main Methods:

  • A study of 115 STEMI patients undergoing successful PPCI.
  • Assessment of microvascular resistance (IMR) using the index of microvascular resistance.
  • Correlation analysis between CHA2DS2-VASc score, IMR, and echocardiographic parameters.

Main Results:

  • Patients with higher IMR (≥40 U) exhibited significantly higher CHA2DS2-VASc scores (p < 0.001).
  • CHA2DS2-VASc score strongly correlated with increased IMR and indicators of cardiac dysfunction.
  • Multivariate analysis identified CHA2DS2-VASc score ≥4 as optimal for predicting MVD (IMR ≥40) in STEMI patients.

Conclusions:

  • Increased CHA2DS2-VASc score is associated with a higher incidence of MVD (elevated IMR) after PPCI in STEMI.
  • The CHA2DS2-VASc score may serve as a practical, cost-effective tool for predicting MVD risk in these patients.
  • Lower systolic blood pressure and stent diameter also correlate with MVD post-PPCI.
Abstract

Keywords:
CHA2DS2-VASc scoreIndexed microvascular resistanceST-segment elevation myocardial infarction

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