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Both HAS-BLED score and ATRIA score are used for predicting bleeding risk in patients with atrial fibrillation (AF) undergoing anticoagulation. However, the predictive ability for major bleeding event (MBE) and intracranial hemorrhage (IH) of these two scoring systems have not been compared in Japanese AF population. Moreover, Asians had been shown to have greater IH risk compare to Westerners.
We prospectively included 232 ambulatory patients (142 male, 70.2±10.2 years old) with AF on anticoagulation therapy, and followed-up for median of 5.7 years. Endpoints were MBE and IH. A standardized MBE definition was used and defined as one of the following: fatal bleeding, IH, or bleeding associated with ≥2 g/dL hemoglobin drop or requiring transfusion ≥ 2 units or requiring surgery.
HAS-BLED and ATRIA scores were calculated and mean values were 1.83±0.91, and 2.80±2.44, respectively. During follow-up, 43 MBEs which include 15 IH were observed. Predictive ability of HAS-BLED score and ATRIA score for MBE were comparable in reciever-operating curve analysis (c-statistics: 0.64 vs 0.67, P=0.52). However, c-statistics for IH was significantly superior in HAS-BLED (0.74 vs 0.56, P=0.047).
Predicting ability of HAS-BLED score and ATRIA score were comparable for prediction MBE. However, HAS-BLED score was preferred to ATRIA score given the predicting ability for IH in Japanese AF patients with anticoagulation therapy.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias: AF/SVT VIII
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1237-46
- 2013 American College of Cardiology Foundation