Key result
Individual components of CHA2DS2-VASc and HAS-BLED risk scores provided more distinguishability for oral anticoagulant treatment decisions than the aggregate scores themselves.
Why the study?
Guidelines recommend that oral anticoagulant treatment decisions in atrial fibrillation balance thromboembolic and bleeding risks, but how risk scores and their components influence real-world prescribing decisions required evaluation.
Do individual components of CHA2DS2-VASc and HAS-BLED scores influence real-world oral anticoagulant prescribing decisions in patients with nonvalvular atrial fibrillation?
Cohort
Do individual components of CHA2DS2-VASc and HAS-BLED scores influence real-world oral anticoagulant prescribing decisions in patients with nonvalvular atrial fibrillation?
Individual components of thromboembolic and bleeding risk scores, particularly bleeding risk factors, drive real-world oral anticoagulant prescribing decisions more than the aggregate scores themselves.
Physicians' OAC decisions in nonvalvular AF may not balance thromboembolic and bleeding risks equally; leaves open how to optimize guideline adherence.
Background: Guidelines indicate that oral anticoagulant (OAC) treatment decisions in atrial fibrillation should be based on a balanced consideration of thromboembolic and bleeding risk. Materials & methods: A retrospective cohort of nonvalvular atrial fibrillation patients were identified. Univariate logistic regression and conditional inference trees were used to quantify the importance of the CHA2DS2-VASc and modified HAS-BLED scores and their individual components on OAC treatment decisions. Results: The individual components of these risk scores provided more distinguishability between treated and untreated patients than the risk scores themselves, with bleeding risk factors strongly associated with nontreatment. Conclusion: While individual components of risk scores drive OAC treatment decisions according to guidelines, the relationship between bleeding risk factors and nontreatment warrants further consideration.
No takes yet. Share an insight, caveat, or question.
Besford et al. (2021) conducted a cohort in Nonvalvular atrial fibrillation. CHA2DS2-VASc and modified HAS-BLED scores was evaluated on Oral anticoagulant (OAC) treatment decisions. Individual components of CHA2DS2-VASc and HAS-BLED risk scores provided more distinguishability for oral anticoagulant treatment decisions than the aggregate scores themselves.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: