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Utility of CHA2DS2-VASc and HAS-BLED Scores as Predictor of Thromboembolism and Bleeding After Left Ventricular Assist Device Implantation.

Kemal, Hatice S; Ertugay, Serkan; Nalbantgil, Sanem; Ozturk, Pelin; Engin, Cagatay; Yagdi, Tahir; Ozbaran, Mustafa
doi: 10.1097/MAT.0000000000000541
Original Article: PDF Only

Ischemic and hemorrhagic events are the common causes of morbidity and mortality after continuous-flow left ventricular assist device implantation (CF-LVAD). CHA2DS2-VASc score predicts thromboembolic (TE) event risk and HAS-BLED score predicts bleeding risk in patients on anti-coagulant with atrial fibrillation. We aimed to evaluate if these scoring systems would be predictive of TE and bleeding complications following 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 INR 2-3) as well as 300 mg of aspirin daily. Median length of support was 316 days (range 31-1060) 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 following CF-LVAD implantation, while baseline CHA2DS2-VASc score was not predictive of TE events.

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