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Prediction Model for Significant Bleeding in Patients with Supratherapeutic International Normalized Ratio After Oral Administration of Warfarin.

Published on Jun 1, 2019in Clinical Drug Investigation2.158
· DOI :10.1007/s40261-019-00774-9
Leili Pourafkari10
Estimated H-index: 10
(Tabriz University of Medical Sciences),
Aidin Baghbani-Oskouei1
Estimated H-index: 1
(Shahid Beheshti University of Medical Sciences and Health Services)
+ 4 AuthorsNader D. Nader23
Estimated H-index: 23
(UB: University at Buffalo)
Abstract
Background and Objective The use and range of indications for anticoagulation therapy are steadily growing. The objective of this study was to develop a scoring model to predict the occurrence of significant bleeding in patients taking warfarin with a supra-therapeutic international normalized ratio.
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References31
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#1Xiaoxi Yao (Mayo Clinic)H-Index: 13
#2Bernard J. Gersh (Mayo Clinic)H-Index: 132
Last. Peter A. Noseworthy (Mayo Clinic)H-Index: 32
view all 7 authors...
The increasing adoption of non–vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF) necessitates a reassessment of bleeding risk scores. Because known risk factors for bleeding are largely the same as for stroke, we hypothesize that stroke risk scores could also be used to identify patients with high bleeding risks. We aimed to compare the performance of 2 stroke risk scores (Congestive Heart failure, hypertension, Age ≥75 [doubled], Diabetes, Stroke...
10 CitationsSource
#2Francisco Marín (University of Murcia)H-Index: 44
Last. Gregory Y.H. Lip (University of Birmingham)H-Index: 141
view all 8 authors...
Abstract Background Atrial fibrillation (AF) patients eligible for cardioversion tend to be younger and are at lower risk than ‘general' AF clinic populations. We evaluated the incidence of major bleeding and death, as well as the predictive value of the HAS-BLED score in non-valvular AF patients who underwent electrical cardioversion (ECV). Methods Consecutive non-valvular AF patients who underwent ECV were recruited. Major bleeding episodes and mortality were recorded. Factors associated with ...
3 CitationsSource
#1Ziad Hijazi (Uppsala University)H-Index: 24
#2Jonas Oldgren (Uppsala University)H-Index: 46
Last. Lars Wallentin (Uppsala University)H-Index: 124
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Summary Background The benefit of oral anticoagulation in atrial fibrillation is based on a balance between reduction in ischaemic stroke and increase in major bleeding. We aimed to develop and validate a new biomarker-based risk score to improve the prognostication of major bleeding in patients with atrial fibrillation. Methods We developed and internally validated a new biomarker-based risk score for major bleeding in 14 537 patients with atrial fibrillation randomised to apixaban versus warfa...
142 CitationsSource
#1Keitaro Senoo (University of Birmingham)H-Index: 13
#2Marco Proietti (University of Birmingham)H-Index: 20
Last. Gregory Y.H. Lip (University of Birmingham)H-Index: 141
view all 4 authors...
Abstract Objectives Various bleeding risk prediction schemes, such as the Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized Ratio, Elderly, Drugs/alcohol (HAS-BLED), Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA), and Outcomes Registry for Better Informed Treatment (ORBIT) scores, have been proposed in patients with atrial fibrillation. We compared the relative predictive values of these bleeding risk scores ...
53 CitationsSource
#1Emily C. O’Brien (Duke University)H-Index: 19
#2DaJuanicia N. Simon (Duke University)H-Index: 10
Last. Eric D. Peterson (Duke University)H-Index: 149
view all 13 authors...
Background Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. Objectives We sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based AF population. Methods We analysed data from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), a prospective registry that...
141 CitationsSource
#1Wengen Zhu (NCU: Nanchang University)H-Index: 8
#2Wenfeng He (NCU: Nanchang University)H-Index: 5
Last. Hong KuiH-Index: 20
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Our objective was to compare the diagnostic accuracy between the HAS-BLED score and any of HEMORR2HAGES, ATRIA, CHADS2, or CHA2DS2-VASc scores in anticoagulated patients with atrial fibrillation. We systematically searched the Cochrane Library, MEDLINE, PubMed, and Embase databases for relevant studies. Data were extracted and analyzed according to predefined clinical endpoints. Eleven studies were identified. Discrimination analysis demonstrates that HAS-BLED has no significant C-statistic diff...
41 CitationsSource
#1Lars WallentinH-Index: 124
#2Ziad HijaziH-Index: 24
Last. Agneta SiegbahnH-Index: 63
view all 12 authors...
Background— Growth differentiation factor 15 (GDF-15), high-sensitivity troponin, and N-terminal pro-brain natriuretic peptide levels are predictive of death and cardiovascular events in healthy elderly subjects, patients with acute coronary syndrome, and patients with heart failure. High-sensitivity troponin I and N-terminal pro-brain natriuretic peptide are also prognostic in patients with atrial fibrillation. We evaluated the prognostic value of GDF-15 alone and in addition to clinical charac...
110 CitationsSource
#1Lars Wallentin (Uppsala University)H-Index: 124
#2Ziad Hijazi (Uppsala University)H-Index: 24
Last. Agneta Siegbahn (Uppsala University)H-Index: 63
view all 12 authors...
91 CitationsSource
#1Daniel Caldeira (University of Lisbon)H-Index: 18
#2João Costa (University of Lisbon)H-Index: 26
Last. Joaquim J. Ferreira (University of Lisbon)H-Index: 44
view all 5 authors...
Introduction Atrial fibrillation (AF) patients’ major bleeding risk should be evaluated through risk scores such as HAS-BLED, HEMORR2HAGES or ATRIA. These scores were validated in independent studies with different methods. Therefore, we aimed to review and estimate the value added by ATRIA and HEMORR2HAGES compared to HAS-BLED.
19 CitationsSource
#1Vanessa Roldán (University of Murcia)H-Index: 34
#2Francisco Marín (University of Murcia)H-Index: 44
Last. Gregory Y.H. Lip (University of Birmingham)H-Index: 141
view all 8 authors...
Background Despite the clear net clinical benefit of oral anticoagulation for stroke prevention in patients with atrial fibrillation (AF), the occurrence of major bleeding events may be devastating. The HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) bleeding risk score was first described in 2010 and is recommended in European and Canadian guidelines to estimate major ...
129 CitationsSource
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