Background: The fundamental pathophysiological basis of acute coronary syndrome (ACS) is the creation of an intracoronary thrombosis as a result of atherosclerotic plaque rupture and disruption of coronary blood flow (CBF). The amount of intracoronary thrombus load is related to a poor outcome among individuals with ACS. Objective: To assess the ability of CHA2DS2-VASc score to predict high pre procedural intracoronary thrombus burden among individuals with non-ST segment elevation myocardial infarction (NSTEMI) who were undergoing revascularization therapy [Percutaneous Coronary Intervention (PCI)]. Patients and Methods: This prospective study enrolled 100 patients above 18 years and admitted/referred to our hospital with acute NSTEMI. The patients underwent PCI for the evaluation of cardiac risk assessment at Cardiology Department in Benha University and Materia Teaching Hospital during the period from January 2023 to January 2024. Results: No significant differences in ischemic changes, arrhythmia and RWMA were found among groups p>0.05. CHA2DS2-VASc and Killip class were independent predictors for high thrombus burden (HTB) with p values < 0.001. Cut-off value of CHA2DS2-VASc score was > 3.5 with sensitivity of 68 %, specificity of 74%, and AUC of 0.758. Conclusion: When the cutoff value is > 3.5, CHA2DS2-VASc score is a reliable indicator of the intracoronary thrombosis load in individuals with NSTEMI receiving initial PCI.