atrial fibrillation and stroke prevention - Continuing Medical ...
atrial fibrillation and stroke prevention - Continuing Medical ...
atrial fibrillation and stroke prevention - Continuing Medical ...
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Essentials in Primary Care Conference<br />
Wednesday, July 31, 2013<br />
HASBLED<br />
Risk #points Major Bleeding<br />
High Risk<br />
(>4%/yr)<br />
Moderate Risk<br />
(2-4%/yr)<br />
Low Risk<br />
( 4 pts 6-16%/yr<br />
2-3 pts 2- 4%/yr<br />
0-1 pts 0-1%/yr<br />
Pisters R, et al. Chest 2010: 138: 1093<br />
Lip GY, et al J Am Coll Cardiol. 2011;57(2):173-180.<br />
Roldan V et al. Chest 2013 Jan; 143: 179.<br />
Bleeding Risk Prediction Generally Poor:<br />
The HAS-BLED Score Best Improves The<br />
Reclassification of One’s Bleeding Risk<br />
• Investigators compared the HAS-BLED, ATRIA, <strong>and</strong> older<br />
HEMORRHAGES score in A Fib cohort<br />
• Independent predictors of bleeding were age > 75, <strong>and</strong><br />
age > 65, alcohol excess, anemia, <strong>and</strong> heart failure<br />
• Bleeding Risk Estimations by Clinicians is Poor <strong>and</strong><br />
Anticoagulant Prescribing Does Not Reflect Bleeding Risk<br />
• HAS-BLED score performed well <strong>and</strong> helped reclassify<br />
bleeding risk over other bleeding risk scores tested.<br />
Lip GY et al. Circ Arrhythm Electrophysiol. 2012; 5:941-948.<br />
Roldan V et al. Chest 2013 Jan; 143: 179.<br />
Jan Basile, MD<br />
Atrial Fibrillation & Stroke Prevention
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