Abstract
Backgrounds: Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. Methods and Results: We retrospectively studied 924 AF patients who were prescribed with direct oral anticoagulants (DOAC) in a single center cohort between May 2011 and July 2015. Using Cox proportional hazards regression, 3 factors were identified to be associated with bleeding among those patients over 1.9 year-follow up. The predictive performance of 3-item score (BAD score: the sum of the point values of the following parameters; bleeding history, age (≥75yrs) and dual antiplatelet therapy) and 3 existing risk scores (HAS-BLED, ORBIT, and ATRIA) were then assessed in the sequel cohort between Aug 2015 and Jun 2016. BAD score had good ability to identify those who bled in an external validation population (C-index: BAD score, 0.63; HAS-BLED, 0.61; ORBIT, 0.64; ATRIA, 0.59). The risk of bleeding increased with higher BAD score. Conclusions: BAD score might be a useful and simple bleeding risk score in AF patients with DOAC.
Published Version
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