HAS-BLED score predicts risk of in-hospital major bleeding in patients with acute non-ST segment elevation myocardial infarction

Hsieh, Ming‐Jer; Wang, Chun‐Chieh; Chen, Chun-Chi; Wang, Chunli; Wu, Lung‐Sheng

doi:10.1016/j.thromres.2015.08.015

Cited by 17 publications

(16 citation statements)

References 33 publications

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“…Hsieh, et al, who reported that the HAS-BLED score exhibited a similar accuracy for the risk assessment as CRUSADE and ACUITY-HORIZONS in patients with NSTEMI, however we observed dissimilar results when it was applied to all patients with ACS. 15) Although the HAS-BLED score includes several factors different from the other three RS systems (an abnormal liver function test, alcohol use, NSAIDs use, and high INR), the presence of these four factors was found in < 1% of our patients. Of nine factors, only five were frequently observed in our patients with AMI; thus, based on this study, we do not recommend the use of the HAS-BLED score for predicting the 30-day bleeding rate in the AMI population owing to its lowest predictive value.…”

Section: Comparison Of Rsmentioning

confidence: 56%

“…However, the HAS-BLED RS did not exhibit similar results and had a poor calibration and discrimination power. Because the ACUITY-HORIZONS RS model has the highest AUC, suggesting that this RS model has the best predictive power among the four RS systems, we further classified the patients into the following four groups: 4) (1) low risk, < 10; (2) moderate risk, 10-14; (3) high risk, [15][16][17][18][19]; and (4) very high risk, >20. Figure 2 demonstrates the comparison between the percentages of predicted and observed 30-day TIMI serious bleeding incidents.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary Intervention

et al. 2019

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We investigated the accuracy of various bleeding risk scores to estimate the bleeding risk in patients with acute myocardial infarction (AMI) managed with percutaneous coronary intervention (PCI) access via the radial artery. We retrospectively enrolled 1,651 patients who were definitively diagnosed with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI). We assessed the predictive validities of 30-day bleeding events in various scoring systems using receiver operating characteristic curves. Overall, ACUITY-HORIZONS exhibited the highest area under the curve to predict 30-day bleeding, followed by ACTION and CRUSADE; HAS-BLED displayed the lowest score. With a cutoff of 17, ACUITY-HORIZONS demonstrated the best discrimination for the Thrombolysis in Myocardial Infarction (TIMI) 30-day serious bleeding rate. We observed significant differences among all-cause death, cardiovascular death, and major adverse cardiac events between the ACUITY-HORIZONS groups with a score of !17 and > 17. ACUITY-HORIZONS score > 17, initial systolic blood pressure (SBP) < 90 mmHg, and Killip III and IV upon admission positively predicted the 30-day bleeding risk, whereas myocardial infarction (MI) and TIMI major bleeding within 30 days, heart failure at admission, and initial SBP < 90 mmHg positively predicted the 30-day mortality. Comparatively, ACUITY-HORIZON is the most reliable system in predicting 30-day bleeding for patients with AMI via transradial PCI. In the transradial scenario, bleeding and MI within 30 days are substantially related to 30-day mortality.

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Section: Comparison Of Rsmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary Intervention

et al. 2019

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“…5 In another study, the HAS-BLED score was also found to be useful in predicting in-hospital major bleeding risk in NSTEMI patients, together with the CRUSADE and ACUITY-HORIZONS scores. 6 All these studies have emphasised that the HAS-BLED score, which is as useful as other scoring systems, is more practical and easy to apply. The ease of calculating the HAS-BLED score and its ease of implementation in clinical practice further increases the importance of this bleeding risk scoring system.…”

Section: Discussionmentioning

confidence: 99%

Performance of HAS-BLED and CRUSADE risk scores for the prediction of haemorrhagic events in patients with stable coronary artery disease

Yıldırım

Uku

Bilen

et al. 2019

CVJA

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We aimed to compare the power of the HAS-BLED and CRUSADE risk scores in predicting in-hospital bleeding events in patients with stable coronary artery disease undergoing elective coronary angiography. A total of 405 consecutive patients were included in the study. The mean HAS-BLED score was significantly higher (p < 0.001) in the in-hospital bleeding group. In patients with a HAS-BLED score ≥ 3, the in-hospital bleeding rate was significantly higher than in those with a HAS-BLED score < 3 (p < 0.001). Receiver operating characteristic curve analysis revealed that the HAS-BLED score was superior in predicting in-hospital bleeding events compared to the CRUSADE score [area under the curve (AUC) = 0.684 vs 0.569, respectively, p = 0.002]. Also in the percutaneous coronary intervention subgroup, the HAS-BLED score was superior to the CRUSADE score (AUC = 0.722 vs 0.520, respectively, p = 0.002). We showed that the HAS-BLED and CRUDASE scores are helpful in stable patients undergoing elective coronary angiography. Our results suggest that as a practical, easy-to-implement and more predictive scoring system, the HAS-BLED score was more useful for predicting in-hospital bleeding in patients who did not present with acute coronary syndrome.

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“…The HAS-BLED score is another system that, although it is intended to assess the risk of bleeding in patients with atrial fibrillation treated with anticoagulants, is particularly useful in patients with acute coronary syndrome (ACS) (Pisters et al 2010) It is easy to administer and includes important variables such as alcohol use, liver dysfunction, and a previous history of bleeding. (Hsieh et al 2015;Taha et al 2015) The authors of the PRECISE-DAPT score use individualized data from eight randomized controlled trials to develop a hemorrhagic risk assessment system that determines the duration of DAPT in patients who have indications to receive such therapy. Compared to previous scores, the PRECISE-DAPT score is the only that offers long-term stratification of bleeding risk and also takes into account the variable "prior bleeding", which weighs four times more than other variables in the assessment.…”

Section: Bleeding Risk Assessment Scoresmentioning

confidence: 99%

Antiplatelet therapy after PCI in patients with high risk of bleeding

Zheleva-Kyuchukova¹,

Гелев²

2020

PHAR

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The progress of percutaneous coronary interventions (PCI) over the last few decades facilitated treatment of increasingly complex patient populations. The introduction of drug-eluting stents (DESs) led to need of stronger and prolonged inhibition of platelets which in turn increased the incidence of bleeding complications. The identification and management of patients at high bleeding risk (HBR) during and after percutaneous coronary interventions (PCI) is still problematic in everyday clinical practice.

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HAS-BLED score predicts risk of in-hospital major bleeding in patients with acute non-ST segment elevation myocardial infarction

Cited by 17 publications

References 33 publications

Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary Intervention

Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary Intervention

Performance of HAS-BLED and CRUSADE risk scores for the prediction of haemorrhagic events in patients with stable coronary artery disease

Antiplatelet therapy after PCI in patients with high risk of bleeding

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