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Published on: February 26, 2013
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Differences in Perceived and Predicted Bleeding Risk in Older Adults With Atrial Fibrillation: The SAGE-AF Study
Benita A Bamgbade1, David D McManus2,3, Robert Helm4
1Department of Pharmacy and Health System Sciences Northeastern University Boston MA.
Journal of the American Heart Association
|August 16, 2021
Summary
Most patients with atrial fibrillation on oral anticoagulants underestimate their bleeding risk. Clinicians must ensure patients understand potential bleeding dangers to improve safety and outcomes.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Limited research exists on patient bleeding risk perception versus calculated risk in atrial fibrillation patients using oral anticoagulants.
- Understanding patient risk perception is crucial for managing oral anticoagulant therapy in atrial fibrillation.
Purpose of the Study:
- To investigate the underestimation of bleeding risk among elderly atrial fibrillation patients on oral anticoagulants.
- To identify characteristics and patient-reported outcomes associated with bleeding risk underestimation.
Main Methods:
- Prospective cohort study (SAGE-AF) of patients aged 65+ with atrial fibrillation and CHA2DS2-VASc score ≥2 on oral anticoagulants.
- Comparison of patient self-reported bleeding risk with HAS-BLED score-predicted risk.
- Analysis of demographic and comorbidity factors influencing risk perception.
Main Results:
- 68% of participants underestimated their bleeding risk.
- Non-White individuals and women showed lower odds of underestimating risk.
- History of bleeding, hypertension, stroke, and renal disease increased the odds of underestimation.
Conclusions:
- Over two-thirds of atrial fibrillation patients on oral anticoagulants underestimate bleeding risk.
- Comorbidities and prior bleeding events are linked to higher underestimation rates.
- Enhanced patient education on bleeding risk is essential for safe oral anticoagulant use.
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