The Utility Of HAS-BLED Score In Predicting The Bleeding Risk Of Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention Receiving Anticoagulation And Dual Anti-platelet Therapy: A Single Center Retrospective Cohort Study

Abstract

Background : The Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly and Drugs/alcohol (HAS-BLED) score is a validated bleeding risk prediction tool in patients with atrial fi brillation taking oral anticoagulation. Its predictive value in patients with atrial fi brillation undergoing percutaneous coronary intervention receiving combination of anticoagulation and antiplatelet therapy is unknown. This retrospective cohort study sought to validate the accuracy of HAS-BLED score in predicting the bleeding risk in patients with atrial fi brillation who underwent percutaneous coronary intervention receiving both anti-coagulation and dual antiplatelet therapy. Method : We calculated HAS-BLED score in 186 patients with AF undergoing coronary stenting and assessed the incidence of bleeding events de fi ned by the International Society on Thrombosis and Hemostasis (ISTH) bleeding scale. Results : The mean age of the patients was 72. The proportion of male to female was 2.93: 1. Using a HAS-BLED cut off of ≥ 3, a signi fi cantly higher incidence of bleeding was detected in the high HAS-BLED compared to the low HAS-BLED cohort. Such difference of bleeding incidence remained signi fi cant in the triple therapy subgroup whereas it became statistically insigni fi cant in the dual-antiplatelet subgroup. The predictive performance was modest (AUC 0.673, 95% CI, 0.535 e 0.811, p ¼ 0.028). Conclusion : HAS-BLED score is a simple and useful tool to predict bleeding risk in a group of atrial fi brillation patients who require triple therapy after percutaneous coronary intervention.