Validation Of The HAS-BLED Tool In Atrial Fibrillation Patients Receiving Rivaroxaban.

Area of Science:

• Cardiology
• Pharmacology
• Clinical Research

Background:

• Atrial fibrillation (Afib) increases stroke risk, necessitating antithrombotic therapy.
• Antithrombotic use in Afib patients heightens bleeding risk.
• The HAS-BLED score predicts bleeding in warfarin users but lacks validation for rivaroxaban.

Purpose of the Study:

• To evaluate the predictive ability of the HAS-BLED score for major bleeding events in patients with atrial fibrillation treated with rivaroxaban.
• To assess the correlation between HAS-BLED scores and bleeding risk in this patient population.

Main Methods:

• Retrospective case-control study at University of Tennessee Medical Center.
• Included adult Afib patients on rivaroxaban for ≥6 months with adequate stroke risk scores.
• Compared bleeding events with HAS-BLED scores using c-statistic analysis.

Main Results:

• 15 major bleeding cases identified from 9621 records; 90 controls selected.
• HAS-BLED showed some diagnostic ability (c-statistic = 0.68, p=0.07) but was not statistically significant.
• Major bleeding patients had higher rates of prior bleeding, concomitant antiplatelet use, and HAS-BLED scores ≥3.

Conclusions:

• The HAS-BLED score demonstrated potential diagnostic utility for major bleeding in rivaroxaban-treated Afib patients.
• Statistical significance was not achieved due to a limited sample size, warranting further investigation.