Associação do Escore CHA2DS2-VASc com o Fenômeno de Não-Refluxo após Intervenção Coronária Percutânea: Uma Revisão Sistemática e Metanálise

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.