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Anticoagulation therapy

New score for hemorrhage risk

Nature Reviews Cardiology volume 8, page 481 (2011)Cite this article

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A new scoring scheme to predict the risk of warfarin-associated hemorrhage in patients with atrial fibrillation (AF) has been published by researchers from the ATRIA (Anticoagulation and Risk Factors in AF) study group based at Kaiser Permanente in the US. Warfarin is commonly prescribed to patients with AF to reduce the risk of thrombosis, but according to Dr Margaret Fang, lead author of the report, “anticoagulants can significantly reduce a person's risk of AF-related stroke; however, anticoagulants also [confer] significant risks—in particular, an increased risk of bleeding.”

The investigators used data from 9,186 patients with AF in the ATRIA study, and identified five variables that were more likely to occur in patients who experienced major hemorrhage compared with those individuals who did not. On the basis of statistical tests, each variable was assigned a score as follows: anemia (hemoglobin <13 g/dl in men and <12 g/dl in women), 3 points; severe renal disease (estimated glomerular filtration rate <30 ml/min, or dialysis-dependent), 3 points; age ≥75 years, 2 points; previous hemorrhage, 1 point; and diagnosed hypertension, 1 point. On the resultant 10-point scale, patients with a score of 0–3 points were defined as 'low risk' and had hemorrhage rates <0.8% per year; 'high-risk' patients (5–10 points) had hemorrhage rates >5.8% per year.

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ORIGINAL RESEARCH PAPER

  1. Fang, M. C. et al. A new risk scheme to predict warfarin-associated hemorrhage. The ATRIA (Anticoagulation and Risk Factors in Atiral Fibrillation) study. J. Am. Coll. Cardiol. 58, 395–401 (2011)

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  1. Gregory B. Lim
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Lim, G. New score for hemorrhage risk. Nat Rev Cardiol 8, 481 (2011). https://doi.org/10.1038/nrcardio.2011.117

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  • DOI: https://doi.org/10.1038/nrcardio.2011.117

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