Why the study?
The study aimed to assess the relationship between implantable cardioverter-defibrillator therapies and CHA2DS2-VASc and HAS-BLED scores.
Are CHA2DS2-VASc and HAS-BLED scores associated with the delivery of ICD therapies in patients with implantable cardioverter-defibrillators?
Are CHA2DS2-VASc and HAS-BLED scores associated with the delivery of ICD therapies in patients with implantable cardioverter-defibrillators?
CHA2DS2-VASc and HAS-BLED scores are not associated with the likelihood of receiving appropriate or inappropriate ICD therapies, whereas reduced ejection fraction and single-chamber ICDs are independent risk factors.
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Supports dual score use for AF risk balance; leaves open whether integration improves outcomes in practice.
CĂl: CHA2DS2-VASc (srdeÄnĂ selhĂĄnĂ, hypertenze, vÄk > 75 let, diabetes mellitus, cĂŠvnĂ mozkovĂĄ pĹĂhoda v anamnĂŠze, cĂŠvnĂ onemocnÄnĂ, vÄkovĂŠ rozmezĂ 65-74 let, pohlavĂ) a HAS-BLED (hypertenze, abnormĂĄlnĂ funkce ledvin/jater, cĂŠvnĂ mozkovĂĄ pĹĂhoda, nestabilnĂ INR, starĹĄĂ osoby, drogy/alkohol) jsou skĂłrovacĂ systĂŠmy, s jejichĹž pomocĂ lze hodnotit moĹžnost vzniku cĂŠvnĂ mozkovĂŠ pĹĂhody a krvĂĄcenĂ pĹi fibrilaci sĂnĂ. CĂlem naĹĄĂ studie bylo posoudit vztah mezi implantovatelnĂ˝mi kardiovertery-defibrilĂĄtory (ICD) a hodnotami skĂłre CHA2DS2-VASc a HAS-BLED. Metody: Po kontrole ĂşdajĹŻ o pacientech starĹĄĂch 18 let, jimĹž byl v obdobĂ 2014-2019, bez ohledu na dĹŻvod, implantovĂĄn ICD a u nichĹž bylo zjiĹĄtÄno, Ĺže jejich kardiostimulĂĄtor byl alespoĹ dvakrĂĄt zkontrolovĂĄn v pĹŻlroÄnĂm intervalu, bylo do naĹĄĂ retrospektivnĂ studie zaĹazeno celkem 398 pacientĹŻ. SkĂłre CHA2DS2-VASc a HAS-BLED byla vypoÄtena bÄhem implantace zaĹĂzenĂ a pĹi poslednĂm kontrolnĂm vyĹĄetĹenĂ. VĂ˝sledky: LĂŠÄba s pouĹžitĂm ICD se provĂĄdÄla u 148 pacientĹŻ (vhodnĂ˝ vĂ˝boj [n = 118] a nevhodnĂ˝ vĂ˝boj [n = 30]); ICD nemÄlo implantovĂĄno 250 pacientĹŻ. SkĂłre CHA2DS2-VASc a HAS-BLED byla v obou skupinĂĄch podobnĂĄ (p = 0,64, resp. p = 0,60). SkĂłre CHA2DS2-VASc a HAS-BLED byla pĹi dĂŠlce sledovĂĄnĂ s mediĂĄnem 5,5 roku u pacientĹŻ s vhodnĂ˝m a nevhodnĂ˝m vĂ˝bojem podobnĂĄ (p = 0,89, resp. p = 0,85). Podle multivariaÄnĂ regresnĂ analĂ˝zy jsou nezĂĄvislĂ˝mi rizikovĂ˝mi faktory lĂŠÄby pomocĂ ICD snĂĹženĂĄ ejekÄnĂ frakce, pouĹžitĂ jednodutinovĂŠho ICD a dlouhodobĂ˝ odstup od implantace (p < 0,05). ZĂĄvÄry: Hodnoty CHA2DS2-VASc a HAS-BLED nejsou spojeny s lĂŠÄbou pomocĂ ICD.
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Alsancak et al. (2021) studied this question.
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