{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:12:54Z","timestamp":1771233174460,"version":"3.50.1"},"reference-count":13,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T00:00:00Z","timestamp":1603670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and purpose: Left atrial appendage closure (LAAC) is an option for stroke prevention in atrial fibrillation patients. Randomized studies have demonstrated the effectiveness and safety of LAAC but included patients with an average risk of stroke and bleeding complications. The current study aimed to assess the extended utility of CHA2DS2VASc (congestive heart failure; hypertension; age \u226575 years [doubled]; type 2 diabetes; previous stroke, transient ischemic attack, or thromboembolism [doubled]; vascular disease; age 65 to 75 years; and sex category) and HAS-BLED (hypertension; abnormal renal\/liver function; stroke; bleeding history or predisposition; labile INR, elderly, drugs\/alcohol concomitantly) scores for qualification and prognosis after LAAC. Methods: The study population comprised 270 patients aged 72.8 \u00b1 8.78 years. The occluders used were the Amplatzer Amulet (N = 205), Amplatzer Cardiac Plug (N = 53), and Watchman device (N = 12). The prognosis after LAAC was analyzed for different cohorts of patients distinguished based on different CHA2DS2VASc and HAS-BLED scores. The mean duration of follow-up was 21.6 \u00b1 10.3 months. Results: The observed rates of ischemic stroke and bleeding were much lower than that expected (2.2% vs. 5.6%, and 0.76% vs. 6.05%, respectively). The mortality rate did not differ concerning the CHA2DS2CVASc score. It was significantly lower (8.3%) for HAS-BLED &lt; 3, and it raised to 17.9% for HAS-BLED = 3 and to 25.9% for HAS-BLED &gt; 3. Significant differences (p = 0.003) occurred for Kaplan\u2013Meier curves for extreme HAS-BLED subgroups. A composite endpoint was most often found in high\/very high risk of bleeding patients. Conclusions: HAS-BLED, but not CHA2DS2CVASc score, may be a useful tool to predict the prognosis of patients after LAAC. Qualification for LAAC based on the risk of stroke should not differ from qualification for anticoagulation. Despite the worse prognosis of patients with the highest bleeding risk, this group is likely to experience the greatest benefit from reducing the bleeding risk from LAAC.<\/jats:p>","DOI":"10.3390\/jcm9113438","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T21:21:00Z","timestamp":1604006460000},"page":"3438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Extended Utility of CHA2DS2VASc and HAS-BLED Scores in the Selection for Transcutaneous Left Atrial Appendage Closure"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4856-8511","authenticated-orcid":false,"given":"Witold","family":"Streb","sequence":"first","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy SUM, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Mitr\u0119ga","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy SUM, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanis\u0142aw","family":"Morawski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy SUM, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5064-8217","authenticated-orcid":false,"given":"Wiktoria","family":"Kowalska","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy SUM, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zbigniew","family":"Kalarus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy SUM, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Olesen, J.B., Lip, G.Y., Hansen, M.L., Hansen, P.R., Tolstrup, J.S., Lindhardsen, J., Selmer, C., Ahlehoff, O., Olsen, A.M.S., and Gislason, G.H. 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Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/j.hrthm.2017.05.038","article-title":"Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1-year follow-up outcome data of the EWOLUTION trial","volume":"14","author":"Boersa","year":"2017","journal-title":"Heart Rhythm"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.jacc.2019.12.040","article-title":"The NCDR Left Atrial Appendage Occlusion Registry","volume":"75","author":"Freeman","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1016\/j.jcin.2020.06.003","article-title":"The Impact of CHA2DS2-VASc and HAS-BLED Scores on Clinical Outcomes in the Amplatzer Amulet Study","volume":"13","author":"Tarantini","year":"2020","journal-title":"J. Am. Coll. Cardiol. Intv."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3438\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:28:38Z","timestamp":1760178518000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,26]]},"references-count":13,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["jcm9113438"],"URL":"https:\/\/doi.org\/10.3390\/jcm9113438","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,26]]}}}