Vascular Health and Risk Management · Jun 11, 2026

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

By Wojciechowska C, Tułecki Ł, Jacheć W et al.

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.

doi.org/10.2147/vhrm.s590625 Open access PubMed 42311621 Biomarkers