{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T01:54:49Z","timestamp":1781142889265,"version":"3.54.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,1,7]]},"abstract":"\n Background<\/jats:title>\n \n We hypothesized that multiple cardiovascular comorbidities, incorporated in the\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score, may be useful in the assessment of ventricular tachyarrhythmias (\n VTAs<\/jats:styled-content>\n ) and mortality risk in heart failure (\n HF<\/jats:styled-content>\n ) patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We evaluated the association between the\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score (dichotomized as high at the upper quartile [\u22655] and further assessed as a continuous measure) and the risk of\n VTA<\/jats:styled-content>\n and death among 1804 patients enrolled in MADIT\u2010CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy). A high\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score (n=464; 26%) was inversely associated with the risk of any\n VTA<\/jats:styled-content>\n (hazard ratio [\n HR<\/jats:styled-content>\n ]: 0.64;\n P<\/jats:italic>\n =0.001), fast\n VTA<\/jats:styled-content>\n >200\u00a0beats\/min (\n HR<\/jats:styled-content>\n ; 0.51;\n P<\/jats:italic>\n <0.001), and appropriate implantable cardioverter\u2010defibrillator shocks (\n HR<\/jats:styled-content>\n : 0.60;\n P<\/jats:italic>\n <0.001). In contrast, a high score was directly correlated with mortality risk (HR: 1.92;\n P<\/jats:italic>\n <0.001) and the risk of\n HF<\/jats:styled-content>\n or death (\n HR<\/jats:styled-content>\n : 1.60;\n P<\/jats:italic>\n <0.001). Consistently, each 1\u2010U increment in\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c was associated with a significant 13% (\n P<\/jats:italic>\n =0.003) reduction in\n VTA<\/jats:styled-content>\n risk but a corresponding 33% (\n P<\/jats:italic>\n <0.001) increase in mortality risk. Patients with a high\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score and left bundle\u2010branch block derived a pronounced 53% (\n P<\/jats:italic>\n <0.001) reduction in the risk of\n HF<\/jats:styled-content>\n or death with cardiac resynchronization therapy with defibrillator versus implantable cardioverter\u2010defibrillator\u2013only therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our findings suggest that a high\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score can be used to identify patients with mild\n HF<\/jats:styled-content>\n who have low\n VTA<\/jats:styled-content>\n risk and high morbidity or mortality risk and may derive a pronounced clinical benefit from cardiac resynchronization therapy without a defibrillator. These data suggest a possible role for the\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score in device selection among candidates for biventricular pacing.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.014353","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T10:00:17Z","timestamp":1577786417000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["CHA\n 2<\/sub>\n DS\n 2<\/sub>\n \u2010VASc Score and the Risk of Ventricular Tachyarrhythmic Events and Mortality in MADIT\u2010CRT"],"prefix":"10.1161","volume":"9","author":[{"given":"Eyal","family":"Nof","sequence":"first","affiliation":[{"name":"Leviev Heart Center and Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Kutyifa","sequence":"additional","affiliation":[{"name":"Heart Research Follow\u2010up Program University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"Heart Research Follow\u2010up Program University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Goldberger","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Huang","sequence":"additional","affiliation":[{"name":"Heart Research Follow\u2010up Program University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet K.","family":"Aktas","sequence":"additional","affiliation":[{"name":"Heart Research Follow\u2010up Program University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosero","family":"Spencer","sequence":"additional","affiliation":[{"name":"Heart Research Follow\u2010up Program University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Heart Research Follow\u2010up Program University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Beinart","sequence":"additional","affiliation":[{"name":"Leviev Heart Center and Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2016.02.029"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-017-1608-x"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joa.2017.06.006"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2005.00073.x"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.531"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.04.095"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs253"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz238"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.014353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:55:55Z","timestamp":1715597755000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.014353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,7]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1,7]]}},"alternative-id":["10.1161\/JAHA.119.014353"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.014353","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,7]]},"assertion":[{"value":"2019-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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