Reconsidering the CHA₂DS₂-VASc Score for No-Reflow Risk Stratification after Percutaneous Coronary Intervention

The no-reflow phenomenon remains one of the most complex and clinically challenging complications of percutaneous coronary intervention (PCI).^, Although advanced imaging techniques, novel stent technologies, and contemporary pharmacological therapies are widely used today, there is still no universally accepted scoring system capable of reliably predicting no-reflow either before or during the procedure. This gap remains an important unmet clinical need.^–

In this context, the systematic review and meta-analysis presented by Ozbay et al. make a significant contribution to the existing literature by addressing the association between the CHA₂DS₂-VASc score and the occurrence of no-reflow after PCI. By synthesizing data from ten observational studies involving more than 6,500 patients, the authors demonstrated a significant and consistent association between higher CHA₂DS₂-VASc scores and an increased likelihood of no-reflow. These findings suggest that observations previously reported in single-center studies with relatively small sample sizes are confirmed in a larger population within a more robust methodological approach.^–

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