Long-term bleeding risk prediction in 'real world' patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores

Thrombosis and Haemostasis
María Asunción Esteve-PastorGregory Y H Lip

Abstract

Risk scores in patients with atrial fibrillation (AF) based on clinical factors alone generally have only modest predictive value for predicting high risk patients that sustain events. Biomarkers might be an attractive prognostic tool to improve bleeding risk prediction. The new ABCBleeding score performed better than HAS-BLED score in a clinical trial cohort but has not been externally validated. The aim of this study was to analyze the predictive performance of the ABC-Bleeding score compared to HAS-BLED score in an independent "real-world" anticoagulated AF patients with long-term follow-up. We enrolled 1,120 patients stable on vitamin K antagonist treatment. The HAS-BLED and ABC-Bleeding scores were quantified. Predictive values were compared by c-indexes, IDI, NRI, as well as decision curve analysis (DCA). Median HAS-BLED score was 2 (IQR 2-3) and median ABC-Bleeding was 16.5 (IQR 14.3-18.6). After 6.5 years of follow-up, 207 (2.84%/year) patients had major bleeding events, of which 65 (0.89%/year) had intracranial haemorrhage (ICH) and 85 (1.17%/year) had gastrointestinal bleeding events (GIB). The c-index of HAS-BLED was significantly higher than ABC-Bleeding for major bleeding (0.583 vs 0.518; p=0.025), GIB (0.596 vs 0....Continue Reading

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Citations

Jun 17, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jens Cosedis NielsenChristophe Leclercq
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Jan 28, 2021·Journal of Thrombosis and Haemostasis : JTH·Luise AdamUNKNOWN SWISS-AF Investigators
Feb 1, 2021·Cardiac Electrophysiology Clinics·Jean Jacques NoubiapDennis H Lau
Feb 1, 2021·Cardiac Electrophysiology Clinics·Hani EssaGregory Y H Lip
Jun 16, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giuseppe BorianiUNKNOWN ESC Scientific Document Group
Sep 30, 2017·European Journal of Clinical Investigation·Nasser M Al-DaghriEnrico Vizzardi
Nov 6, 2018·Cardiovascular Research·Ahsan A Khan, Gregory Y H Lip
Dec 10, 2019·Therapeutic Advances in Cardiovascular Disease·Sergio BuccheriDavide Capodanno

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