Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation
Ginés Elvira-Ruiz1
César Caro-Martínez2
Pedro José Flores-Blanco1
Juan José Cerezo-Manchado3
Helena Albendín-Iglesias4
Alejandro Lova-Navarro1
Francisco Arregui-Montoya1
Francisca María Mu(n)oz-Franco1
Natalia García-Iniesta1
Arcadio García-Alberola5
José Luis Bailén-Lorenzo6
Domingo Andrés Pascual-Figal5
Sergio Manzano-Femández5
1.Department of Cardiology, University Hospital Virgen de la Arrixaca, Murcia, Spain;Instituto Murciano de Investigación en Biomedicina(IMIB), Murcia, Spain2.Department of Cardiology, University Hospital Morales Meseguer, Murcia, Spain;Department of Hematology, University Hospital Virgen de la Arrixaca, Murcia, Spain3.Instituto Murciano de Investigación en Biomedicina(IMIB), Murcia, Spain;Department of Hematology, University Hospital Virgen de la Arrixaca, Murcia, Spain4.Instituto Murciano de Investigación en Biomedicina(IMIB), Murcia, Spain;Department of Internal Medicine, University Hospital Virgen de la Arrixaca, Murcia, Spain5.Department of Cardiology, University Hospital Virgen de la Arrixaca, Murcia, Spain;Instituto Murciano de Investigación en Biomedicina(IMIB), Murcia, Spain;School of Medicine, University of Murcia, Murcia, Spain6.Department of Cardiology, Hospital Vega Baja, Alicante, Spain
摘要：Background The identification of modifiable bleeding risk factors may be of relevance.The aim is to evaluate if aortic stenosis (AS)provides additional information to bleeding risk scores for predicting major bleeding (MB) in non-valvular atrial fibrillation (AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagnlation between January 2013 and December 2016.AS was defined as moderate or severe according to European echocardiography guidelines criteria.HASBLED,ATRIA and ORBIT scores were used to evaluate the bleeding risk.MB was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of follow-up.Results 168 (5.8％) patients had AS.Patients with AS had higher risk for MB compared to those without AS (HR =2.13,95％ CI:1.40-3.23,P ＜ 0.001).Patients without AS and low-intermediate bleeding risk (0 points) showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk (2 points) was the highest one.Discrimination and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of follow-up.Conclusions In this population,AS was associated with an increased risk for MB at midterm follow-up.The three scoring systems showed a moderate discriminatory ability for MB.Moreover,the addition of AS was associated with a significant improvement in their predictive accuracy.We suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.
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论文发表日期：2020-03-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 141-148 )
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