Delta CHA₂DS₂-VASc (AUC 0.69; 95% CI 0.54-0.84) and delta HAS-BLED (AUC 0.73; 95% CI 0.55-0.91) scores achieved higher predictive accuracy for stroke and bleeding than baseline scores.
Cohort (n=529)
Does dynamic reassessment of CHA₂DS₂-VASc and HAS-BLED scores improve stroke and bleeding risk prediction compared to baseline scores alone in patients with atrial fibrillation?
Regular reassessment of CHA₂DS₂-VASc and HAS-BLED scores improves the prediction of stroke and bleeding risks in patients with atrial fibrillation compared to baseline assessment alone.
Effect estimate: AUC (95% CI 0.54-0.84)
Absolute Event Rate: 0.69% vs 0.63%
BACKGROUND AND OBJECTIVES: -VASc and HAS-BLED scores over time enhances stroke and bleeding risk prediction. METHODS: In this prospective longitudinal study-based on data from the Iranian Atrial Fibrillation Registry (IRAF)-patients with available CHA₂DS₂-VASc and HAS-BLED scores at baseline, first follow-up (after 6 months), and second follow-up (after 12 months) were included. Univariable and multivariable logistic regression analyses were performed to evaluate the association of CHA₂DS₂-VASc and HAS-BLED scores (i.e., scores at baseline, first follow-up, and their difference defined as delta) with stroke and bleeding risk, respectively. RESULTS: A total of 529 patients (mean age 61.2 ± 14.3 years; 59.7% male) were included. CHA₂DS₂-VASc and HAS-BLED scores increased significantly after 6 and 12 months from recruitment. delta CHA₂DS₂-VASc score (AUC 0.69; 95% CI: 0.54-0.84) and First follow-up CHA₂DS₂-VASc score (AUC 0.70; 95% CI: 0.51-0.88) achieved higher AUCs compared to baseline CHA₂DS₂-VASc score (AUC 0.63; 95% CI: 0.44-0.82). delta HAS-BLED score had the highest AUC (AUC 0.73; 95% CI: 0.55-0.91) compared to baseline (AUC 0.58; 95% CI: 0.43-0.74) and first follow-up HAS-BLED (AUC 0.60; 95% CI: 0.44-0.80) scores. CONCLUSIONS: Regular reassessment of CHA₂DS₂-VASc and HAS-BLED scores is essential in AF patients, as stroke and bleeding risks change over time, emphasizing the need for dynamic risk stratification.
Askarinejad et al. (Thu,) conducted a cohort in Atrial Fibrillation (n=529). Delta CHA₂DS₂-VASc and HAS-BLED scores vs. Baseline scores was evaluated on Stroke risk prediction (AUC) (AUC, 95% CI 0.54-0.84). Delta CHA₂DS₂-VASc (AUC 0.69; 95% CI 0.54-0.84) and delta HAS-BLED (AUC 0.73; 95% CI 0.55-0.91) scores achieved higher predictive accuracy for stroke and bleeding than baseline scores.