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Thromboembolic risk scores in patients with non-obstructive coronary architecture with and without coronary slow

Ömer Genç1, Abdullah Yıldırım2, Gökhan Alıcı2

  • 1Basaksehir Cam & Sakura City Hospital, Department of Cardiology, Istanbul, Turkey.

International Journal of Cardiology
|May 13, 2023
PubMed

Insights

Thromboembolic risk scores, like CHA₂DS₂-VASc-HS, may predict coronary slow flow phenomenon (CSFP) in patients undergoing coronary angiography. The CHA₂DS₂-VASc-HS score demonstrated the best ability to identify CSFP.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Coronary slow flow phenomenon (CSFP) on coronary angiography is linked to adverse outcomes.
  • Assessing thromboembolic risk is crucial in cardiology practice.

Purpose of the Study:

  • To investigate the association between routinely used thromboembolic risk scores and CSFP.
  • To identify which risk score best predicts CSFP in patients with non-obstructive coronary artery disease.

Main Methods:

  • A retrospective case-control study of 505 patients with angina and ischemia.
  • Calculation of multiple thromboembolic risk scores (CHA₂DS₂-VASc, CHA₂DS₂-VASc-HS, ATRIA, etc.).
  • Multivariable logistic regression and pairwise comparisons to assess risk score performance in predicting CSFP.

Main Results:

  • Patients with CSFP had higher rates of male gender, diabetes, smoking, hyperlipidemia, and vascular disease.
  • All calculated risk scores were significantly higher in the CSFP group.
  • The CHA₂DS₂-VASc-HS score was the strongest predictor of CSFP (OR=1.90 per point increase) and showed the best discriminative performance (AUC=0.759) with a cutoff of ≥2.

Conclusions:

  • Thromboembolic risk scores are associated with CSFP in patients with non-obstructive coronary arteries.
  • The CHA₂DS₂-VASc-HS score is a valuable tool for identifying patients with CSFP.
Abstract

Keywords:
AtherosclerosisCHA(2)DS(2)-VASc-HSCoronary slow flow phenomenonHyperlipidemiaThromboembolic risk scoresVascular disease

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