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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
Adult Circulatory Support

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.

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.

Submitted for consideration August 2016; accepted for publication in revised form February 2017.

Disclosure: The authors reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

The results of this study were presented at the European Society of Cardiology Congress, London, September 2015.

Correspondence: Hatice S. Kemal, Department of Cardiology, Near East University, Nicosia, Cyprus. Email:

Copyright © 2017 by the American Society for Artificial Internal Organs