HAS-BLED and CHA2DS2-VASc scores as predictors of bleeding and thrombotic risk after continuous-flow ventricular assist device implantation

Ryan J. Koene, Sithu Win, Niyada Naksuk, Sirtaz N. Adatya, Andrew N. Rosenbaum, Ranjit John, Peter M. Eckman

Research output: Contribution to journalArticle

Abstract

Background HAS-BLED and CHA2DS2-VASc scores predict bleeding in patients on anticoagulation and thromboembolic (TE) risk in patients with atrial fibrillation, respectively. We hypothesized that these scores would be predictive of bleeding and TE complications following continuous-flow ventricular assist device (CF-VAD) implantation.

Methods and Results Baseline HAS-BLED and CHA2DS2-VASc scores were retrospectively determined for 173 consecutive patients who underwent HeartMate II CF-VAD implantation at a single center from 2005 to 2011. Forty-three patients had bleeding (24.9%) and 22 had TE (12.7%) events over a 290 patient-year follow-up period. The mean ± SD HAS-BLED scores were 2.7 ± 1.0 and 1.9 ± 1.1 (P <.0001) in patients with and without bleeding, respectively. The CHA2DS2-VASc scores were 3.6 ± 1.4 and 2.9 ± 1.5 (P =.03) in patients with and without TE events, respectively. A HAS-BLED score of ≥3 was associated with a significantly higher risk of bleeding events compared with a score of <3 (42% vs 15%, respectively; hazard ratio [HR] 3.40, 95% confidence interval [CI] 1.82-6.32; P <.001). A CHA2DS2-VASc score of ≥3 was associated with a higher risk of TE events compared with a score of <3 (18% vs 4%, respectively; HR 4.02, 95% CI 1.19-13.6; P =.025).

Conclusions Baseline HAS-BLED and CHA2DS2-VASc scores of ≥3 conferred significantly higher risks of bleeding and TE, respectively, following HeartMate II implantation.

Original languageEnglish (US)
Pages (from-to)800-807
Number of pages8
JournalJournal of Cardiac Failure
Volume20
Issue number11
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Heart-Assist Devices
Hemorrhage
Confidence Intervals
Atrial Fibrillation

Keywords

  • heart failure
  • hemorrhage clotting
  • risk factors
  • Ventricular assist devices

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

HAS-BLED and CHA2DS2-VASc scores as predictors of bleeding and thrombotic risk after continuous-flow ventricular assist device implantation. / Koene, Ryan J.; Win, Sithu; Naksuk, Niyada; Adatya, Sirtaz N.; Rosenbaum, Andrew N.; John, Ranjit; Eckman, Peter M.

In: Journal of Cardiac Failure, Vol. 20, No. 11, 01.01.2014, p. 800-807.

Research output: Contribution to journalArticle

Koene, Ryan J. ; Win, Sithu ; Naksuk, Niyada ; Adatya, Sirtaz N. ; Rosenbaum, Andrew N. ; John, Ranjit ; Eckman, Peter M. / HAS-BLED and CHA2DS2-VASc scores as predictors of bleeding and thrombotic risk after continuous-flow ventricular assist device implantation. In: Journal of Cardiac Failure. 2014 ; Vol. 20, No. 11. pp. 800-807.
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abstract = "Background HAS-BLED and CHA2DS2-VASc scores predict bleeding in patients on anticoagulation and thromboembolic (TE) risk in patients with atrial fibrillation, respectively. We hypothesized that these scores would be predictive of bleeding and TE complications following continuous-flow ventricular assist device (CF-VAD) implantation.Methods and Results Baseline HAS-BLED and CHA2DS2-VASc scores were retrospectively determined for 173 consecutive patients who underwent HeartMate II CF-VAD implantation at a single center from 2005 to 2011. Forty-three patients had bleeding (24.9{\%}) and 22 had TE (12.7{\%}) events over a 290 patient-year follow-up period. The mean ± SD HAS-BLED scores were 2.7 ± 1.0 and 1.9 ± 1.1 (P <.0001) in patients with and without bleeding, respectively. The CHA2DS2-VASc scores were 3.6 ± 1.4 and 2.9 ± 1.5 (P =.03) in patients with and without TE events, respectively. A HAS-BLED score of ≥3 was associated with a significantly higher risk of bleeding events compared with a score of <3 (42{\%} vs 15{\%}, respectively; hazard ratio [HR] 3.40, 95{\%} confidence interval [CI] 1.82-6.32; P <.001). A CHA2DS2-VASc score of ≥3 was associated with a higher risk of TE events compared with a score of <3 (18{\%} vs 4{\%}, respectively; HR 4.02, 95{\%} CI 1.19-13.6; P =.025).Conclusions Baseline HAS-BLED and CHA2DS2-VASc scores of ≥3 conferred significantly higher risks of bleeding and TE, respectively, following HeartMate II implantation.",
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T1 - HAS-BLED and CHA2DS2-VASc scores as predictors of bleeding and thrombotic risk after continuous-flow ventricular assist device implantation

AU - Koene, Ryan J.

AU - Win, Sithu

AU - Naksuk, Niyada

AU - Adatya, Sirtaz N.

AU - Rosenbaum, Andrew N.

AU - John, Ranjit

AU - Eckman, Peter M.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background HAS-BLED and CHA2DS2-VASc scores predict bleeding in patients on anticoagulation and thromboembolic (TE) risk in patients with atrial fibrillation, respectively. We hypothesized that these scores would be predictive of bleeding and TE complications following continuous-flow ventricular assist device (CF-VAD) implantation.Methods and Results Baseline HAS-BLED and CHA2DS2-VASc scores were retrospectively determined for 173 consecutive patients who underwent HeartMate II CF-VAD implantation at a single center from 2005 to 2011. Forty-three patients had bleeding (24.9%) and 22 had TE (12.7%) events over a 290 patient-year follow-up period. The mean ± SD HAS-BLED scores were 2.7 ± 1.0 and 1.9 ± 1.1 (P <.0001) in patients with and without bleeding, respectively. The CHA2DS2-VASc scores were 3.6 ± 1.4 and 2.9 ± 1.5 (P =.03) in patients with and without TE events, respectively. A HAS-BLED score of ≥3 was associated with a significantly higher risk of bleeding events compared with a score of <3 (42% vs 15%, respectively; hazard ratio [HR] 3.40, 95% confidence interval [CI] 1.82-6.32; P <.001). A CHA2DS2-VASc score of ≥3 was associated with a higher risk of TE events compared with a score of <3 (18% vs 4%, respectively; HR 4.02, 95% CI 1.19-13.6; P =.025).Conclusions Baseline HAS-BLED and CHA2DS2-VASc scores of ≥3 conferred significantly higher risks of bleeding and TE, respectively, following HeartMate II implantation.

AB - Background HAS-BLED and CHA2DS2-VASc scores predict bleeding in patients on anticoagulation and thromboembolic (TE) risk in patients with atrial fibrillation, respectively. We hypothesized that these scores would be predictive of bleeding and TE complications following continuous-flow ventricular assist device (CF-VAD) implantation.Methods and Results Baseline HAS-BLED and CHA2DS2-VASc scores were retrospectively determined for 173 consecutive patients who underwent HeartMate II CF-VAD implantation at a single center from 2005 to 2011. Forty-three patients had bleeding (24.9%) and 22 had TE (12.7%) events over a 290 patient-year follow-up period. The mean ± SD HAS-BLED scores were 2.7 ± 1.0 and 1.9 ± 1.1 (P <.0001) in patients with and without bleeding, respectively. The CHA2DS2-VASc scores were 3.6 ± 1.4 and 2.9 ± 1.5 (P =.03) in patients with and without TE events, respectively. A HAS-BLED score of ≥3 was associated with a significantly higher risk of bleeding events compared with a score of <3 (42% vs 15%, respectively; hazard ratio [HR] 3.40, 95% confidence interval [CI] 1.82-6.32; P <.001). A CHA2DS2-VASc score of ≥3 was associated with a higher risk of TE events compared with a score of <3 (18% vs 4%, respectively; HR 4.02, 95% CI 1.19-13.6; P =.025).Conclusions Baseline HAS-BLED and CHA2DS2-VASc scores of ≥3 conferred significantly higher risks of bleeding and TE, respectively, following HeartMate II implantation.

KW - heart failure

KW - hemorrhage clotting

KW - risk factors

KW - Ventricular assist devices

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