{"title":"一项单中心回顾性队列研究:经皮冠状动脉介入治疗房颤患者接受抗凝和双重抗血小板治疗后出血风险的预测","authors":"Luk Yin Cheung Adrian, Chan Chi Lin Jaclyn","doi":"10.55503/2790-6744.1211","DOIUrl":null,"url":null,"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.","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Luk Yin Cheung Adrian, Chan Chi Lin Jaclyn\",\"doi\":\"10.55503/2790-6744.1211\",\"DOIUrl\":null,\"url\":null,\"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.\",\"PeriodicalId\":53534,\"journal\":{\"name\":\"Journal of the Hong Kong College of Cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Hong Kong College of Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.55503/2790-6744.1211\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Hong Kong College of Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.55503/2790-6744.1211","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:高血压、肾/肝功能异常、中风、出血史或倾向、Labile国际标准化比率、老年人和药物/酒精(HAS-BLED)评分是口服抗凝治疗心房颤动患者的有效出血风险预测工具。它对接受抗凝和抗血小板联合治疗的经皮冠状动脉介入治疗的心房颤动患者的预测价值尚不清楚。这项回顾性队列研究旨在验证HAS-BLED评分在预测接受经皮冠状动脉介入治疗并接受抗凝和双重抗血小板治疗的心房颤动患者出血风险方面的准确性。方法:我们计算了186名接受冠状动脉支架置入术的房颤患者的HAS-BLED评分,并评估了国际血栓与止血学会(ISTH)出血量表定义的出血事件的发生率。结果:患者平均年龄72岁。男女比例为2.93:1。使用≥3的HAS-BLED截距,与低HAS-BLE队列相比,高HAS-BLED队列的出血发生率明显更高。这种出血发生率的差异在三联治疗亚组中仍然显著,而在双抗血小板治疗亚组则变得统计学上不显著。预测性能适中(AUC 0.673,95%CI,0.535 e 0.811,p¼0.028)。结论:HAS-BLED评分是预测一组经皮冠状动脉介入治疗后需要三重治疗的心房颤动患者出血风险的简单而有用的工具。
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
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.
期刊介绍:
The Journal of the Hong Kong College of Cardiology publishes peer-reviewed articles on all aspects of cardiovascular disease, including original clinical studies, review articles and experimental investigations. As official journal of the Hong Kong College of Cardiology, the journal publishes abstracts of reports to be presented at the Scientific Sessions of the College as well as reports of the College-sponsored conferences.