Predictive value of four score systems on the bleeding risk in atrial fibrillation patients treated with dabigatran.
10.3760/cma.j.cn112148-20200617-00492
- VernacularTitle:四种评分系统对服用达比加群的心房颤动患者出血风险的预测价值比较
- Author:
Cong Cong DING
1
;
Bi Ming ZHAN
1
;
Wei ZHOU
2
;
Ming Hui LI
1
;
Li Hua HU
1
;
Hui Hui BAO
3
;
Xiao Shu CHENG
3
Author Information
1. Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
2. Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
3. Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China; Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Dabigatran;
Hemorrhage;
Score systems
- MeSH:
Aged;
Anticoagulants;
Atrial Fibrillation;
China;
Dabigatran;
Humans;
Male;
Middle Aged;
Prospective Studies;
Risk Assessment;
Risk Factors;
Stroke
- From:
Chinese Journal of Cardiology
2020;48(9):748-752
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the predictive value of HAS-BLED, HEMORR2HAGES, ATRIA and ORBIT scores on the bleeding risk in nonvalvular atrial fibrillation (NVAF) patients treated with dabigatran. Methods: Data of 942 NVAF patients participating a non-interventional prospective study of anticoagulant therapy with dabigatran, which was conducted in 12 centers from February 2015 to December 2017 in China, were analyzed. Complete HAS-BLED HEMORR2HAGES, ATRIA and ORBIT bleeding risk scores data and follow-up data were available in the enrolled patients. The endpoint of the study was bleeding events occurred during a 6 months follow-up. Cox proportional hazards models were constructed to analyze the associations between HAS-BLED, HEMORR2HAGES, ATRIA and ORBIT scores and risk of bleeding, and the area under the curve (AUC) of receiver operating characteristics curves (ROC) of each score was used to set the predictive value for bleeding risk. Results: Among the 942 patients, the mean age was (65.3±11.2) years old, 542 (57.5%) were males. A total of 93 (9.9%) bleeding events occurred during follow up, 89 (9.4%) events were minor bleeding, and 4 (0.4%) events were major bleeding. Patients with a high-risk HAS-BLED score had a 1.87-fold increased risk of bleeding compared with low-risk patients (HR = 2.87, 95% CI:1.26-6.51, P = 0.012). There was no statistically significant difference between low-medium-high-risk grading in other scoring systems and bleeding risk (all P>0.05). The AUC (95%CI) of HAS-BLED, HEMORR2HAGES, ATRIA and ORBIT bleeding risk scores were 0.558 (0.525-0.590), 0.520 (0.487-0.553), 0.513(0.480-0.545), 0.523(0.490-0.555), respectively. The AUC of all bleeding score systems were of ≤ 0.700. Conclusion: Among the NVAF patients taking dabigatran in China, the HAS-BLED bleeding risk score is superior to other 3 bleeding risk score on predicting the bleeding risk in these patients, but its predictive value is still relatively low.
