title: The utility of a CHA2DS2-VASc score in predicting the presence of significant stenosis and occlusion of veins with indwelling endocardial leads.
abstract: BACKGROUND
  Currently, there are no studies in which a CHA2DS2-VASc score has been used to predict the risk of venous stenosis and occlusion (VSO) in patients after the implantation of a cardiac implantable electronic device (CIED).
  
  
  METHODS
  The material consists of the records of 223 consecutive patients qualified for transvenous lead extraction, generator change and system revisions or upgrades in whom we assessed the utility of a CHA2DS2-VASc score in the prediction of VSO. The CHA2DS2-VASc score was calculated retrospectively based on the clinical data. The whole study population was divided into two groups, based on the presence (group I) or absence (group II) of VSO. Using the receiver operating characteristic (ROC) curve, we identified the optimal cut-off point for the CHA2DS2-VASc score that allowed the prediction of the absence of VSO.
  
  
  RESULTS
  The venography was performed in 223 consecutive patients aged on average 68.2years (25.7-95.3), 77 females (34.5%). The presence of VSO was detected in 79 (35.4%) patients aged 68.3±14.1years, 30 female (40%) patients-group I. The level of the cut-off point for the CHA2DS2-VASc score that allowed the prediction of the absence of VSO was 3.0.
  
  
  CONCLUSIONS
  In the whole population the incidence of VSO amounted to 35.4%. The result of the CHA2DS2-VASc score was a destimulant of VSO occurrence and was characterized by moderate sensitivity (73.4%) and specificity (42.4%) in predicting the absence of VSO. The most significant factor, which prevented VSO development was diabetes.
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland. Electronic address: krzysiek.boczar@gmail.com.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Boczar
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ząbek
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Dębski
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Haberka
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Rydlewska
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland; Institute of Cardiology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Lelakowski
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Cracow, Poland; Institute of Cardiology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Małecka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology
keywords: CHA(2)DS(2)-VASc score; Pacemaker; Phlebography; Venous occlusion; Venous stenosis