Prediction of No-Reflow Phenomenon Using Newly Defined CHA2DS2-VASc-HSF Score in Diabetic Patients Undergoing Coronary Angiography

Background: Cardiovascular atherosclerosis, and more especially coronary artery disease (CAD), is the main cause of premature death globally. Coronary artery disease treatment must include risk assessment and prevention measures, such as managing risk factors. The risk of thrombosis can be efficiently measured in situations of non-valvular atrial fibrillation (AF) using the CHADS2 and CHA2DS2-VASc scores.
Objectives:  This study aimed to determine whether the CHA2DS2-VASc-HSF score could be used to predict the absence of reflow events in elective coronary angiography patients with diabetes.
Patients and methods: The current research was conducted on 361 cases who underwent elective percutaneous coronary artery intervention at Menoufia University and Matrouh Specialized Cardiac Center. They were classified into two groups: Cohort I [those with a low CHA2DS2-VASc-HSF score (≤ 4)] and cohort II [those with a high CHA2DS2-VASc-HSF score (5-13)]. Participants in cohort I had syntactic scores ranging from 2–13 for low, 14–20 for intermediate, and 21–40 for high. The MBG and traditional TIMI flow grading for each case were taken into consideration.
Results: The findings showed that during elective PCI, all cases exhibited TIMI III flow, and no reflow was found in any of them, nevertheless when TIMI flow grade. People with high or intermediate Syntax scores had a higher average CHA2DS2-VASc-HSF score than those with low Syntax scores, showing a strong and significant correlation between the two types of scores. Whencombined with MBG, it revealed that approximately 2.5% of the cases had no reflow with an increase in cohort II CHA2DS2-VASc-HSF scores, although this relationship was still statistically non-significant. The CHA2DS2-VASc-HSF score was significantly correlated to HbA1c, creatinine, and random blood glucose levels.
Conclusions: Syntax score results demonstrated a relationship between the CHA2DS2-VASc-HSF score and CAD severity and complexity, but no significant correlation was found between the score and the incidence of no reflow in elective PCI cases.