Association of CHA2DS2-VASc Score with No-Reflow Phenomenon after PCI: A Systematic Review and Meta-Analysis


Ozbay M. B., Gullu A., Degirmen S., Nriagu B. N., Ozen Y., YAYLA Ç.

Arquivos Brasileiros de Cardiologia, cilt.123, sa.1, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 123 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.36660/abc.20250356i
  • Dergi Adı: Arquivos Brasileiros de Cardiologia
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Anahtar Kelimeler: Percutaneous Coronary Intervention, Meta-Analysis
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Background: The no-reflow (NR) phenomenon is a serious complication of percutaneous coronary intervention (PCI), associated with poor clinical outcomes. The CHA2DS2-VASc score, originally developed to assess thromboembolic risk in atrial fibrillation, has shown potential in being associated with adverse cardiovascular events, but its predictive value for NR remains uncertain. Objective: To evaluate the association between the CHA2DS2-VASc score and the occurrence of NR in patients undergoing PCI through a systematic review and meta-analysis. Methods: A systematic review of the literature was performed across Cochrane, EMBASE, and PubMed databases to identify studies examining the relationship between the CHA2DS2-VASc score and the occurrence of NR following PCI. A random-effects meta-analysis was conducted, using odds ratios (ORs) and 95% confidence intervals (CIs) as the measures of effect size. Heterogeneity was calculated by using Cochran’s Q test and Higgins’ I2 statistics. Results: A total of 10 studies including 6,557 patients (1,068 NR cases and 5,489 non-NR cases) were analyzed. An elevated CHA2DS2-VASc score was strongly associated with a higher risk of NR occurrence after PCI (OR, 1.86; 95% CI, 1.51–2.29; p < .00001; I2 = 85%). Conclusion: This meta-analysis supports that the CHA2DS2-VASc score may be a useful tool for identifying patients at increased risk of NR during PCI. Further prospective studies are required to validate these findings and optimize risk stratification approaches.