• Gökhan Alıcı, Hasan Ali Barman, Adem Atıcı, Sevil Tuğrul, Ömer Genç, and İrfan Şahin.
• Okmeydani Training and Research Hospital, Department of Cardiology, Darulaceze Street No:25, Okmeydanı 34384, İstanbul, Turkey.
• Int. J. Clin. Pract. 2022 Jan 1; 2022: 8066780.

BackgroundIn patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), a patent infarct-related artery (IRA) on initial angiography is defined as spontaneous reperfusion (SR).ObjectiveThe present study aimed to determine the impact of lesion complexity and the CHA2DS2-VASc score on SR in patients with STEMI.MethodsA total number of 1,641 consecutive patients with STEMI undergoing primary PCI were assessed for this study. Patients were divided into 2 groups, those with SR, SR(+) (n = 239), and those without SR, SR(-) (n = 1402), according to their initial angiography and SR status. CHA2DS2-VASc scores were calculated for all patients. The lesion complexity of coronary artery disease was assessed with the SYNTAX score.ResultsThe CHA2DS2-VASc and SYNTAX scores were significantly lower in the SR(+) group compared to the SR(-) (mean CHA2DS2-VASc, 1.36 ± 0.64 vs. 2.01 ± 0.80, p < 0.001; mean SYNTAX score, 15.51 ± 5.94 vs. 17.08 ± 8.29, p < 0.001). After the multivariate regression analysis, a lower CHA2DS2-VASc (OR = 0.288, p < 0.001), SYNTAX score (OR = 0.920, p=0.007), uric acid (OR = 0.868, p=0.005), CRP (OR = 0.939, p=0.001), BNP (OR = 0.998, p=0.004), and troponin (OR = 0.991, p=0.001) were independent predictors of SR. In-hospital mortality rates were significantly lower in the SR(+) group compared to the SR(-) (0% vs. 6.7%, p < 0.001).ConclusionOur study demonstrated that lesion complexity and the CHA2DS2-VASc score are independently associated with spontaneous reperfusion.Copyright © 2022 Gökhan Alıcı et al.

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