Related Experiment Video
Updated: Apr 4, 2026
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Truly low and high thromboembolic risk - impact of risk scores in real life
Tomasz Ciurus1, Sebastian Sobczak1, Małgorzata Lelonek1
1Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland.
Insights
The CHA2DS2-VASc and HAS-BLED scores effectively identify thromboembolic and bleeding risks in nonvalvular atrial fibrillation patients. Women may have higher bleeding risk but use less antiplatelet therapy.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Anticoagulation therapy is guided by risk stratification scores like CHA2DS2-VASc and bleeding risk assessment using HAS-BLED.
- Nonvalvular atrial fibrillation (AF) management requires accurate risk assessment for thromboembolic events.
Purpose of the Study:
- To evaluate the real-world effectiveness of risk stratification scores in nonvalvular AF patients.
- To assess the predictive accuracy of CHA2DS2-VASc and HAS-BLED in a clinical setting.
Main Methods:
- Analysis of 68 nonvalvular AF patients who initiated anticoagulation.
- Stratification based on CHADS2 and CHA2DS2-VASc scores, including gender analysis.
- Warfarin treatment for high thromboembolic risk patients, considering patient preference.
Main Results:
- 90% of patients were identified as high thromboembolic risk. CHA2DS2-VASc identified patients who were younger, had less hypertension, and lower HAS-BLED scores compared to CHADS2 ≥ 2.
- Women showed a higher incidence of ischemic stroke but less coronary artery disease.
- Bleeding occurred in 13% of patients on warfarin; no thromboembolic complications were recorded.
Conclusions:
- CHA2DS2-VASc and HAS-BLED scores reliably identify low and high thromboembolic risk and bleeding risk in nonvalvular AF.
- Women may face a higher bleeding risk, potentially linked to less frequent antiplatelet therapy use.
Background:
Anticoagulation therapy is followed by analysis of factors used in the CHA2DS2-VASc score and assessing the risk of bleeding (HAS-BLED).
The Aim Of The Study:
The aim of the study was to evaluate in 'real life' risk stratification scores in nonvalvular atrial fibrillation (AF).
Material And Methods:
From 81 consecutive patients who had not yet received anticoagulation, 68 were finally enrolled after exclusion criteria. Patients were analyzed related to risk scores: CHADS2 ≥ 2 (group I) vs. CHADS2 < 2 and CHA2DS2-VASc score ≥ 2 (group II) and gender. Patients at high thromboembolic risk were treated with warfarin, after consideration of the patient's decision.
Results:
At high risk of thromboembolic complications were 61 patients (90%). In 26 subjects (43%, 15 women - 57%) indication for anticoagulation was established by CHA2DS2-VASc. When compared to CHADS2 ≥ 2, these patients were younger (72 ±10 years vs. 63 ±10 years, p = 0.0002), less frequently burdened with arterial hypertension (p = 0.03) and had lower risk in HAS-BLED (1.23 ±0.65 vs. 0.81 ±0.49, p = 0.03). Seven patients (10%) did not require anticoagulation (CHA2DS2-VASc = 0). Compared to men, women more often had ischemic stroke (2 vs. 18%, p = 0.03), but less coronary artery disease (58 vs. 25%, p = 0.005). During 18 months on warfarin, bleeding occurred in 9 patients (13%, 6 women). On dual antiplatelet therapy were 11 patients (16%). No thromboembolic complications were recorded.
Conclusions:
CHA2DS2-VASc and HAS-BLED schemata easily identify real low and high thromboembolic risk patients and bleeding risk. It seems that women present higher risk of bleeding, but less frequent use of antiplatelet therapy.
More Related Videos
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:12Relative Risk
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care