title: Utility of CHA2DS2-VASc and HAS-BLED Scores as Predictor of Thromboembolism and Bleeding After Left Ventricular Assist Device Implantation.
abstract: Ischemic and hemorrhagic events are the common causes of morbidity and mortality after continuous-flow left ventricular assist device (CF-LVAD) implantation. CHA2DS2-VASc score predicts thromboembolic (TE) event risk and HAS-BLED score predicts bleeding risk in patients on anticoagulant with atrial fibrillation (AF). We aimed to evaluate whether these scoring systems would be predictive of TE and bleeding complications after CF-LVAD implantation. From December 2010 to December 2014, 145 patients who underwent CF-LVAD implantation at a single center were included. Mean age was 50.7 ± 11.2 years, and 85.5% were male. Baseline CHA2DS2-VASc and HAS-BLED scores were retrospectively determined for patients with CF-LVADs. After device implantation, all patients were on warfarin (target international normalized ratio 2-3) as well as 300 mg of aspirin daily. Median length of support was 316 days (range 31-1,060), with 22 TE events (15.2%) and 32 bleeding (22.1%) events. The mean CHA2DS2-VASc score was 2.3 ± 1.4 and 2.5 ± 1.2 (p = 0.2) in patients with and without TE event, respectively. The mean HAS-BLED score was 1.8 ± 0.8 and 1.42 ± 0.6 (p = 0.004) in patients with and without bleeding, respectively. Baseline high HAS-BLED score was predictive of bleeding events after CF-LVAD implantation, whereas baseline CHA2DS2-VASc score was not predictive of TE events.
authors.affiliation: From the *Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus; and †Department of Cardiovascular Surgery and ‡ Department of Cardiology, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Hatice S
authors.initials: HS
authors.lastname: Kemal
authors.forename: Serkan
authors.initials: S
authors.lastname: Ertugay
authors.forename: Sanem
authors.initials: S
authors.lastname: Nalbantgil
authors.forename: Pelin
authors.initials: P
authors.lastname: Ozturk
authors.forename: Cagatay
authors.initials: C
authors.lastname: Engin
authors.forename: Tahir
authors.initials: T
authors.lastname: Yagdi
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozbaran
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D013923:Thromboembolism / Q000209:etiology*