Key result
The HAS-BLED score efficiently predicted bleeding events (p=0.0003), with labile INR values significantly increasing bleeding risk (OR 5.356) in atrial fibrillation patients on oral anticoagulants.
Why the study?
Do the CHA2DS2-VASc and HAS-BLED scores accurately predict thromboembolic and bleeding events in patients with nonvalvular atrial fibrillation?
Observational (n=144)
No
Do the CHA2DS2-VASc and HAS-BLED scores accurately predict thromboembolic and bleeding events in patients with nonvalvular atrial fibrillation?
The CHA2DS2-VASc and HAS-BLED scores are effective clinical tools for stratifying the risk of thromboembolic and bleeding events in patients with nonvalvular atrial fibrillation.
Answers are grounded in this paper and cite their sources.
Labile INR may warrant closer monitoring in anticoagulated AF; supports HAS-BLED validation yet leaves practice change to prospective trials.
Introduction . The purpose of this study is to evaluate the risk and the benefit of oral anticoagulant treatment in nonvalvular atrial fibrillation (AF) patients, using the two scores recommended by the guidelines: the CHA2DS2-VASc score and HAS-BLED score. Material and method . We conducted a retrospective observational study on 144 patients with nonvalvular atrial fibrillation, admitted between 1st of July 2013 and 30th September 2013 in the 3rd Medical Clinic of Tîrgu Mureș with a prospectiv follow-up at 6 months. Based on the data collected from the patient charts, the thromboembolic risk was assessed using the CHA2DS2-VASc score and the hemorrhage risk was assessed using the HAS-BLED score. At 6 months, the patients were contacted via telephone and were questioned regarding their state of health, the existence of hospitalizations in the last 6 months, the international normalized ratio (INR) value, the existence of hemorrhagic or thromboembolic events. Results . The group of patients was composed of 70 female and 74 male with the mean age of 70 ±11 years. From the total number of patients 13 (11.7%) had a history of stroke and the CHA2DS2-VASc score revealed that these 13 were in the high risk class. The presence of arterial hypertension and vascular disease were statistically associated with stroke. Hemorrhagic events were encountered in 19 patients (13.19%) and 16 of them had a higher than 3 HAS-BLED score. A history of bleeding, anemia and labile INR were the factors statistically associated with bleeding. Conclusions . The CHA2DS2-VASc score is useful in stratifying patients with AF in risk groups for thromboembolic events while the HAS-BLED score proved to be a useful tool in predicting bleeding events in anticoagulated patients.
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Ionela et al. (2015) conducted an observational in Nonvalvular atrial fibrillation (n=144). Oral anticoagulant treatment was evaluated on Bleeding events associated with labile INR (OR 5.356, 95% CI 1.889-15.188, p=0.0013). The HAS-BLED score efficiently predicted bleeding events (p=0.0003), with labile INR values significantly increasing bleeding risk (OR 5.356) in atrial fibrillation patients on oral anticoagulants.
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