Impact of the HAS-BLED Score on Long-Term Outcomes After Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Clinical Risk Assessment

Background:

• Drug-eluting stents (DES) are standard for coronary artery disease, requiring dual antiplatelet therapy (DAPT) for at least 12 months.
• Dual antiplatelet therapy (DAPT) increases bleeding risk, necessitating accurate bleeding risk stratification in DES patients.
• The HAS-BLED score is a validated tool for assessing bleeding risk in atrial fibrillation patients.

Purpose of the Study:

• To evaluate the predictive value of the HAS-BLED score for major bleeding and mortality in patients post-percutaneous coronary intervention (PCI) with DES implantation.
• To determine if the HAS-BLED score can be utilized for risk stratification in a broader PCI population.

Main Methods:

• Analysis of 1,207 consecutive patients who received DES implantation between 2004 and 2011.
• Patients were stratified into high (≥3) and low (0-2) HAS-BLED score groups.
• Primary outcomes included major bleeding and all-cause mortality, assessed over a median follow-up of 3.6 years.

Main Results:

• The high HAS-BLED score group exhibited significantly higher rates of both major bleeding and death compared to the low HAS-BLED score group.
• Multivariate Cox regression analysis confirmed that a high HAS-BLED score was independently associated with increased risk of death and major bleeding.
• Patients in the high HAS-BLED score group presented with more severe comorbidities.

Conclusions:

• The HAS-BLED score demonstrates significant predictive value for major bleeding and mortality in patients undergoing PCI with DES, irrespective of atrial fibrillation status.
• This score serves as a valuable tool for risk stratification and clinical decision-making in patients treated with drug-eluting stents.
• The findings support the broader application of the HAS-BLED score beyond atrial fibrillation for assessing bleeding and survival risks post-PCI.