The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.
A Novel User-Friendly Score (HAS-BLED) To Assess 1-Year Risk of Major Bleeding in Patients With Atrial Fibrillation
Open accessAbstract
OBJECTIVE: Despite extensive use of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and the increased bleeding risk associated with such OAC use, no handy quantification tool for assessing this risk exists. We aimed to develop a practical risk score to estimate the 1-year risk for major bleeding (intracranial, hospitalization, hemoglobin decrease > 2 g/L, and/or transfusion) in a cohort of real-world patients with AF. METHODS: Based on 3,978 patients in the Euro Heart Survey on AF with complete follow-up, all univariate bleeding risk factors in this cohort were used in a multivariate analysis along with historical bleeding risk factors. A new bleeding risk score termed HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years), Drugs/alcohol concomitantly) was calculated, incorporating risk factors from the derivation cohort. RESULTS: Fifty-three (1.5%) major bleeds occurred during 1-year follow-up. The annual bleeding rate increased with increasing risk factors. The predictive accuracy in the overall population using significant risk factors in the derivation cohort (C statistic 0.72) was consistent when applied in several subgroups. Application of the new bleeding risk score (HAS-BLED) gave similar C statistics except where patients were receiving antiplatelet agents alone or no antithrombotic therapy, with C statistics of 0.91 and 0.85, respectively. CONCLUSION: This simple, novel bleeding risk score (HAS-BLED) provides a practical tool to assess the individual bleeding risk of real-world patients with AF, potentially supporting clinical decision making regarding antithrombotic therapy in patients with AF.
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Cites
Dabigatran versus warfarin in patients with atrial fibrillation
Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Eikelboom, J., Oldgren, J., Parekh, A., Pogue, J., Reilly, P. A., Themeles, E., Varrone, J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0905561 · Cited by 11,215
Hart, R. G., Pearce, L. A., & Aguilar, M. I. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-12-200706190-00007 · Cited by 4,793
Miyasaka, Y., Barnes, M. E., Gersh, B. J., Cha, S. S., Bailey, K. R., Abhayaratna, W. P., Seward, J. B., & Tsang, T. S. M. (2006) · Circulation · doi:10.1161/circulationaha.105.595140 · Cited by 2,564
Effect of clopidogrel added to aspirin in patients with atrial fibrillation
The ACTIVE Investigators (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0901301 · Cited by 2,102
Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study
Heeringa, J., van der Kuip, D. A. M., Hofman, A., Kors, J. A., van Herpen, G., Stricker, B. H. C., Stijnen, T., Lip, G. Y. H., & Witteman, J. C. M. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehi825 · Cited by 1,939
Self-citationMant, J., Hobbs, F. R., Fletcher, K., Roalfe, A., Fitzmaurice, D., Lip, G. Y., & Murray, E. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61233-1 · Cited by 1,556
Hughes, M., Lip, G. Y. H., & on behalf of the Guideline Development Group for the NICE national clinical guideline for management of atrial fibrillation in primary and secondary care (2007) · QJM · doi:10.1093/qjmed/hcm076 · Cited by 217
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V.-P., Jankowska, E. A., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw128 · Cited by 11,429
Self-citationESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012
Authors/Task Force Members, McMurray, J. J. V., Adamopoulos, S., Anker, S. D., Auricchio, A., Böhm, M., Dickstein, K., Falk, V., Filippatos, G., Fonseca, C., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs104 · Cited by 6,879
Self-citation2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418
Self-citation2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V.-P., Jankowska, E. A., et al. (2016) · European Journal of Heart Failure · doi:10.1002/ejhf.592 · Cited by 5,866
Ruff, C. T., Giugliano, R. P., Braunwald, E., Hoffman, E. B., Deenadayalu, N., Ezekowitz, M. D., Camm, A. J., Weitz, J. I., Lewis, B. S., Parkhomenko, A., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(13)62343-0 · Cited by 5,051
Metadata
- Authors
- Pisters, R., Lane, D. A., Nieuwlaat, R., de Vos, C. B., Crijns, H. J. G. M., & Lip, G. Y. H.
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 138
- Issue
- 5
- Pages
- 1093-1100
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2127985968
- Cited by
- 4,505
- References
- 7
- FWCI
- 126.72
- Type
- journal article
- Language
- en
- Open access
- green
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- CoChat. (2026). Citation check: A Novel User-Friendly Score (HAS-BLED) To Assess 1-Year Risk of Major Bleeding in Patients With Atrial Fibrillation. https://app.cochat.ai/papers/10.1378/chest.10-0134
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- Pisters, R., Lane, D. A., Nieuwlaat, R., de Vos, C. B., Crijns, H. J. G. M., & Lip, G. Y. H. (2010). A Novel User-Friendly Score (HAS-BLED) To Assess 1-Year Risk of Major Bleeding in Patients With Atrial Fibrillation. Chest. https://doi.org/10.1378/chest.10-0134
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