Background: CHA2DS2VASc score is a predictive tool that enables estimation the risk of developing ischemic stroke and thrombo-embolism in cardiac patient. Intracoronary thrombus formation due to atherosclerotic plaque rupture and the interruption of coronary blood flow constitute the main pathophysiology underlying acute coronary syndrome Objective: Assessment of the ability of CHA2DS2-VASc score for predicting high intracoronary thrombus and to evaluate the prognostic value of it in assessment of stroke, re-infarction and mortality in patients with Non- ST-Elevation Myocardial Infarction (NSTEMI). Methods: Sixty-six patients were enrolled in our study, divided into 2 groups; Group I (n = 33 patients) represents low thrombus grade, Group II (n = 33 patients) represents high thrombus grade. All patients were subjected to coronary angiography to assess degree of stenosis and coronary flow by thrombolysis in myocardial infarction (TIMI) grade score. Sensitivity, specificity and diagnostic accuracy of CHA2DS2-VASc in prediction of high thrombus burden were assessed. Results: The mean age for Group I and II was 62.21±9.51 and 66.67±9.14 years respectively. LV average global systolic strain (AGS) was significantly lower in group I and II when compared to group III. Age, Killip class and LA diameters are highly significant predictors for incidence of high CHA2DS2-VASc. The diagnostic accuracy of CHA2DS2-VASc in prediction of high thrombus burden was 83.3% with cut-off value 4. Conclusion: CHA2DS2-VASc score is a good predictor of intracoronary thrombus burden in non ST segment elevation myocardial infarction patients undergoing primary PCI at a cutoff value equal or more than 4 and also can be a predictor of the outcomes after primary PCI.