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CHA2DS2-VASc and CHA2DS2-VA Scores as Predictors of Short- and Long-Term Mortality Following Transvenous Lead Extraction.

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Τίτλος: CHA2DS2-VASc and CHA2DS2-VA Scores as Predictors of Short- and Long-Term Mortality Following Transvenous Lead Extraction.
Συγγραφείς: Wojciechowska C; 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland., Tułecki Ł; Department of Cardiac Surgery, The Pope John Paul II Province Hospital, Zamość, Poland., Jacheć W; 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland., Nowosielecka D; Department of Cardiac Surgery, The Pope John Paul II Province Hospital, Zamość, Poland.; Department of Cardiology, The Pope John Paul II Province Hospital, Zamość, Poland., Wojciechowski P; Student's Scientific Group, 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland., Polewczyk A; Świętokrzyskie Cardiology Centre, The Jan Kochanowski University and Health Sciences, Kielce, Poland., Kutarski A; 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
Πηγή: Vascular health and risk management [Vasc Health Risk Manag] 2026 Jun 11; Vol. 22, pp. 590625. Date of Electronic Publication: 2026 Jun 11 (Print Publication: 2026).
Τύπος έκδοσης: Journal Article; Comparative Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101273479 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-2048 (Electronic) Linking ISSN: 11766344 NLM ISO Abbreviation: Vasc Health Risk Manag Subsets: MEDLINE
Imprint Name(s): Original Publication: Auckland : Dove Medical Press, c2005-
Ιατρικοί όροι (MeSH): Atrial Fibrillation*/mortality , Atrial Fibrillation*/diagnosis , Atrial Fibrillation*/therapy , Defibrillators, Implantable*/adverse effects , Device Lead Extraction*/mortality , Device Lead Extraction*/adverse effects , Pacemaker, Artificial*/adverse effects , Decision Support Techniques*, Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Comorbidity ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome
Περίληψη: Background: Multimorbidity significantly affects prognosis in patients after transvenous lead extraction (TLE). The CHA2DS2-VASc and CHA2DS2-VA scores, widely used for stroke risk stratification in atrial fibrillation, include clinical factors that are also associated with long-term mortality.
Purpose: To evaluate the usefulness of the CHA2DS2-VASc and CHA2DS2-VA scores in predicting short- and long-term mortality in patients following non-laser TLE.
Methods: This retrospective study included 3822 patients who underwent non-laser TLE between March 2006 and April 2023 at high-volume centres. The median follow-up was 1848 days (Q1-Q3: 815-3146 days). Patients were stratified into two groups according to CHA2DS2-VASc score (<3 vs. ≥3). 30-day, 1-year, and 3-year, and overall follow-up mortality were assessed. Cox proportional hazards models were used to identify independent predictors of death during short and long follow-up.
Results: Patients with CHA2DS2-VASc ≥3 had significantly higher mortality at 30 days 1 year, 3 years, and during overall follow-up compared with those scoring <3. A cut-off ≥3 showed 80.6% sensitivity and 62.3% specificity for predicting 3-year mortality. Mortality increased progressively with higher CHA2DS2-VASc scores (Spearman's r = 0.983, p<0.001). The multivariate Cox regression demonstrated that number of points on CHA2DS2-VASc and CHA2DS2-VA scores were independent predictors long-term mortality, alongside Charlson comorbidity index, atrial fibrillation, infective TLE indications, and renal dysfunction. Each 1-point increase in the CHA2DS2VA score was associated with an 11.7% increase in the risk of death. In sex-specific analysis, the risk increased by 33.0% per point in females (HR 1.330; p<0.001) and by 20.6% in males (HR 1.206; p<0.001).
Conclusion: CHA2DS2-VASc and CHA2DS2-VA score may be a useful tool for predicting the risk of death during long-term observation of patients after TLE. Incorporation of this score into clinical decision-making may improve risk stratification and support individualized management of patients undergoing TLE.
(© 2026 Wojciechowska et al.)
Competing Interests: The authors declare no conflicts of interest in this work.
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Contributed Indexing: Keywords: CHA2DS2-VASc score; cardiac implantable electronic device; comorbidity; lead extraction; mortality risk; risk stratification
Entry Date(s): Date Created: 20260618 Date Completed: 20260618 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC13269031
DOI: 10.2147/VHRM.S590625
PMID: 42311621
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1178-2048
DOI:10.2147/VHRM.S590625