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Novel Bleeding Risk Score for Patients with Atrial Fibrillation on Oral Anticoagulants, including Direct Oral Anticoagulants.
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 4615119
Author(s) Adam, Luise; Feller, Martin; Syrogiannouli, Lamprini; Del-Giovane, Cinzia; Donzé, Jacques; Baumgartner, Christine; Segna, Daniel; Floriani, Carmen; Roten, Laurent; Fischer, Urs; Aeschbacher, Stefanie; Moschovitis, Giorgio; Schläpfer, Jürg; Shah, Dipen; Amman, Peter; Kobza, Richard; Schwenkglenks, Matthias; Kühne, Michael; Bonati, Leo; Beer, Jürg; Osswald, Stefan; Conen, David; Aujesky, Drahomir; Rodondi, Nicolas; SWISS-AF Investigators,
Author(s) at UniBasel Schwenkglenks, Matthias
Year 2021
Title Novel Bleeding Risk Score for Patients with Atrial Fibrillation on Oral Anticoagulants, including Direct Oral Anticoagulants.
Journal Journal of thrombosis and haemostasis : JTH
Volume 19
Pages / Article-Number 931-940
Keywords SWISS-AF; atrial fibrillation; bleeding risk; direct oral anticoagulants; oral anticoagulants
Abstract

Balancing bleeding risk and stroke risk in patients with atrial fibrillation (AF) is a common challenge. Though several bleeding risk scores exist, most have not included patients on direct oral anticoagulants (DOAC). We aimed at developing a novel bleeding risk score for patients with AF on oral anticoagulants (OAC) including both, vitamin K antagonists (VKA) and DOACs.; We included patients with AF on OAC from a prospective multicentre cohort study in Switzerland (SWISS-AF). The outcome was time to first bleeding. Bleeding events were defined as major or clinically relevant non-major bleeding. We used backward elimination to identify bleeding risk variables. We derived the score using a point score system based on the beta coefficients from the multivariable model. We used the Brier score for model calibration (<0.25 indicating good calibration), and Harrel's c-statistics for model discrimination. .; We included 2,147 patients with AF on OAC (72.5% male, mean age 73.4 ± 8.2 years), of whom 1209 (56.3%) took DOAC. After a follow-up of totally 4.4. years, a total of 255 (11.9%) bleeding events occurred. After backward elimination, age>75 years, history of cancer, prior major haemorrhage and arterial hypertension remained in the final prediction model. The Brier score was 0.23 (95% CI 0.19- 0.27), the c-statistics at 12 months was 0.71 (95%CI 0.63 - 0.80).; In this prospective cohort study of AF patients and predominantly DOAC users, we successfully derived a bleeding risk prediction model with good calibration and discrimination.

ISSN/ISBN 1538-7836
Full Text on edoc
Digital Object Identifier DOI 10.1111/jth.15251
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/33501722
   

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