|HAS-BLED parameters (52)∗|
|Abnormal renal function‡|
|Abnormal liver function§|
|History of or predisposition to (anemia) major bleeding|
|Labile INR (VKA)‖|
|Elderly (>65 years)|
|Concomitant use of an antiplatelet agent or nonsteroidal anti-inflammatory drug|
|Alcohol or drug usage history (≥8 drinks/week)¶|
|Additional items included in the periprocedural management algorithm|
|Prior bleed event within 3 months (including intracranial hemorrhagic)|
|Quantitative or qualitative platelet abnormality|
|INR above the therapeutic range at the time of the procedure (VKA)|
|Bleed history from previous bridging|
|Bleed history with similar procedure|
ALT = alanine transaminase; AST = aspartate transaminase; HAS-BLED = Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INRs, Elderly, Drugs or alcohol; INR = international normalized ratio; ULN = upper limit of normal; and VKA = vitamin K antagonist.
↵∗ Each bullet is counted as 1 point. A HAS-BLED score ≥3 was shown to be highly predictive of bleeding events, with 1 point being given for the presence of each individual parameter (54).
↵† Defined in HAS-BLED as systolic blood pressure >160 mm Hg.
↵‡ Defined in HAS-BLED as presence of chronic dialysis, renal transplantation, or serum creatinine ≥200 micromol/L.
↵§ Defined in HAS-BLED as chronic hepatic disease (e.g., cirrhosis) or biochemical evidence of significant hepatic derangement (e.g., bilirubin >2× ULN, AST or ALT >3× ULN).
↵‖ Defined in HAS-BLED as time in the therapeutic range <60%.
↵¶ Defined in HAS-BLED as >8 U/week.