Zhang QY, et al. - Since no-reflow phenomenon (NRP) represents a grave complication of primary percutaneous coronary intervention (PPCI) and represents an independent predictor of poor prognosis, so, this retrospective single-center analysis was undertaken to identify a simple but effective risk stratification approach for NRP prediction. This study involved 454 consecutive patients who received a diagnosis of acute ST-segment elevation myocardial infarction and managed by PPCI. Based on post-PPCI thrombolysis in the myocardial infarction flow rate, the patients were split into the NRP group and the control group. Experts computed CHADS₂, CHA₂DS₂-VASc, and CHA₂DS₂-VASc-HSF [a new score including three new variables: hyperlipidemia (H), smoking (S), and a family history of coronary heart disease (F)] scores for all patients. NRP incidence was estimated to be 17.6%. NRP was independently predicted by creatine kinase-myocardial band, Killip class, stent length, and multivessel disease. Findings showed the utility of CHADS₂, CHA₂DS₂-VASc, and CHA₂DS₂-VASc-HSF scores as simple instruments to predict NRP, but the highest predictive value was displayed by the CHA₂DS₂-VASc-HSF score. Therefore, an optimal tool for predicting high-risk patients may be the CHA₂DS₂-VASc-HSF score.