Presence of Microvascular Dysfunction and CHA2DS2-VASc Score in Patients with ST-Segment Myocardial Infarction after Primary Percutaneous Coronary Intervention.
Ragab A Mahfouz, Marwa M Gad, Mohamed Arab, Moei-E Deen Abulfotouh
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Abstract
Objective: We aimed to investigate the relation between CHA2DS2-VASc score and microvascular dysfunction (MVD) assessed by the index of microvascular resistance (IMR) immediately after primary percutaneous intervention (PPCI) for patients with ST-segment elevation myocardial infarction (STEMI).
Subjects and methods: The study included 115 consecutive patients with STEMI who underwent successful PPCI. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and IMR. Also, we assessed echocardiographic changes with respect to CHA2DS2-VASc score.
Results: Subjects were stratified into 2 groups based on IMR 2DS2-VASc score (p < 0.001). CHA2DS2-VASc score was significantly correlated with increased left atrial volume index, diastolic dysfunction, wall motion score index, and inversely correlated left ventricular ejection. Moreover, CHA2DS2-VASc score was strongly correlated with IMR (p < 0.001). At multivariate analysis, low systolic blood pressure, stent diameter, and CHA2DS2-VASc score were associated with MVD. Besides, CHA2DS2-VASc score ≥4 was the optimal value in predicting MVD (IMR ≥40) in STEMI patients.
Conclusions: The data of the current study point out that increased CHA2DS2-VASc score, lower systolic blood pressure <90 mm Hg, and stent diameter are associated with increased incidence of MVD (increased IMR) after PPCI of STEMI. We suggest that the CHA2DS2-VASc score may be a simple, inexpensive useful risk score for the prediction of MVD risk after PPCI for STEMI patients.
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