Academic Journal
Dynamic assessment of CHA2DS2-VASc and HAS-BLED scores for predicting ischemic stroke and major bleeding in atrial fibrillation patients
| العنوان: | Dynamic assessment of CHA2DS2-VASc and HAS-BLED scores for predicting ischemic stroke and major bleeding in atrial fibrillation patients |
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| المؤلفون: | Serna, María José, Rivera-Caravaca, José Miguel, López-Gálvez, Raquel, Soler-Espejo, Eva, Lip, Gregory Y. H., Marín, Francisco, Roldán, Vanessa |
| المصدر: | Serna , M J , Rivera-Caravaca , J M , López-Gálvez , R , Soler-Espejo , E , Lip , G Y H , Marín , F & Roldán , V 2024 , ' Dynamic assessment of CHA2DS2-VASc and HAS-BLED scores for predicting ischemic stroke and major bleeding in atrial fibrillation patients ' , Revista Espanola de Cardiologia (English Edition) , vol. 77 , no. 10 , pp. 835-842 . https://doi.org/10.1016/j.rec.2024.02.011 |
| سنة النشر: | 2024 |
| المجموعة: | Aalborg University (AAU): Publications / Aalborg Universitet: Publikationer |
| مصطلحات موضوعية: | Aged, Anticoagulants/therapeutic use, Atrial Fibrillation/complications, Female, Follow-Up Studies, Hemorrhage/epidemiology, Humans, Ischemic Stroke/diagnosis, Male, Middle Aged, Risk Assessment/methods, Risk Factors, Stroke/etiology |
| الوصف: | INTRODUCTION AND OBJECTIVES: Stroke and bleeding risks in atrial fibrillation (AF) are often assessed at baseline to predict outcomes years later. We investigated whether dynamic changes in CHA2DS2-VASc and HAS-BLED scores over time modify risk prediction. METHODS: We included patients with AF who were stable while taking vitamin K antagonists. During a 6-year follow-up, all ischemic strokes/transient ischemic attacks (TIAs) and major bleeding events were recorded. CHA2DS2-VASc and HAS-BLED were recalculated every 2-years and tested for clinical outcomes at 2-year periods. RESULTS: We included 1361 patients (mean CHA2DS2-VASc and HAS-BLED 4.0±1.7 and 2.9±1.2). During the follow-up, 156 (11.5%) patients had an ischemic stroke/TIA and 269 (19.8%) had a major bleeding event. Compared with the baseline CHA2DS2-VASc, the CHA2DS2-VASc recalculated at 2 years had higher predictive ability for ischemic stroke/TIA during the period from 2 to 4 years. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) showed improvements in sensitivity and better reclassification. The CHA2DS2-VASc recalculated at 4 years had better predictive performance than the baseline CHA2DS2-VASc during the period from 4 to 6 years, with an improvement in IDI and an enhancement of the reclassification. The recalculated HAS-BLED at 2-years had higher predictive ability than the baseline score for major bleeding during the period from 2 to 4 years, with significant improvements in sensitivity and reclassification. A slight enhancement in sensitivity was observed with the HAS-BLED score recalculated at 4 years compared with the baseline score. CONCLUSIONS: In AF patients, stroke and bleeding risks are dynamic and change over time. The CHA2DS2-VASc and HAS-BLED scores should be regularly reassessed, particularly for accurate stroke risk prediction. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| DOI: | 10.1016/j.rec.2024.02.011 |
| الاتاحة: | https://vbn.aau.dk/da/publications/278fd324-6d21-4396-b748-9aff7e638920 https://doi.org/10.1016/j.rec.2024.02.011 https://vbn.aau.dk/ws/files/747056709/Serna_et_al._2024_._Dynamic_assessment_of_CHA2DS2-VASc_and_HAS-BLED_scores_for_predicting_ischemic_stroke_and_major_bleeding_in_atrial_fibrillation_patients.pdf http://www.scopus.com/inward/record.url?scp=85192309379&partnerID=8YFLogxK |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.8ABC95C1 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.rec.2024.02.011 |
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