European Journal of Molecular & Clinical Medicine

Abstract

Background: CHA2DS2VASc score is a predictive tool that enables estimation the risk of
developing ischemic stroke and thrombo-embolism in cardiac patient. Intracoronary thrombus
formation due to atherosclerotic plaque rupture and the interruption of coronary blood flow
constitute the main pathophysiology underlying acute coronary syndrome Objective:
Assessment of the ability of CHA2DS2-VASc score for predicting high intracoronary thrombus
and to evaluate the prognostic value of it in assessment of stroke, re-infarction and mortality in
patients with Non- ST-Elevation Myocardial Infarction (NSTEMI). Methods: Sixty-six patients
were enrolled in our study, divided into 2 groups; Group I (n = 33 patients) represents low
thrombus grade, Group II (n = 33 patients) represents high thrombus grade. All patients were
subjected to coronary angiography to assess degree of stenosis and coronary flow by
thrombolysis in myocardial infarction (TIMI) grade score. Sensitivity, specificity and diagnostic
accuracy of CHA2DS2-VASc in prediction of high thrombus burden were assessed. Results:
The mean age for Group I and II was 62.21±9.51 and 66.67±9.14 years respectively. LV
average global systolic strain (AGS) was significantly lower in group I and II when compared to
group III. Age, Killip class and LA diameters are highly significant predictors for incidence of
high CHA2DS2-VASc. The diagnostic accuracy of CHA2DS2-VASc in prediction of high
thrombus burden was 83.3% with cut-off value 4. Conclusion: CHA2DS2-VASc score is a good
predictor of intracoronary thrombus burden in non ST segment elevation myocardial infarction
patients undergoing primary PCI at a cutoff