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ACP Journal Club |20 May 2014

In anticoagulated patients with AF, HAS-BLED predicted major bleeding better than CHADS2 and CHA2DS2-VASc

Maura Marcucci, MD

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Roldan V, Marín F, Manzano-Fernández S, et al. The HAS-BLED score has better prediction accuracy for major bleeding than CHADS2 or CHA2DS2-VASc scores in anticoagulated patients with atrial fibrillation. J Am Coll Cardiol. 2013;62:2199-204. 24055744

GIM/FP/GP:

Cardiology:

Hematol/Thrombo:

Neurology:

In patients with atrial fibrillation (AF) who are receiving stable oral anticoagulants, does a bleeding risk score (HAS-BLED) predict major bleeding better than stroke risk scores (CHADS2 or CHA2DS2-VASc)?
Retrospective cohort study to compare HAS-BLED with CHADS2 and CHA2DS2-VASc.
Outpatient anticoagulation clinic.
1370 patients (median age 76 y, 53% women, median follow-up 996 d) who had permanent or paroxysmal AF, were receiving oral anticoagulation therapy with acenocoumarol, and had an international normalized ratio (INR) of 2 to 3 over the past 6 months. Exclusion criteria were prosthetic heart valves, an acute coronary syndrome, stroke (ischemic or embolic), valvular AF, hemodynamic instability, or hospital admission or surgery in the past 6 months.
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Marcucci M. In anticoagulated patients with AF, HAS-BLED predicted major bleeding better than CHADS2 and CHA2DS2-VASc. Ann Intern Med. ;160:JC13. doi: 10.7326/0003-4819-160-10-201405200-02013

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Published: Ann Intern Med. 2014;160(10):JC13.

DOI: 10.7326/0003-4819-160-10-201405200-02013

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