Major bleeding risk assessment in atrial fibrillation patients taking vitamin K antagonists

Autores

  • Fernando Pivatto Júnior Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  • André Luís Ferreira da Silva Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  • Indira Valente Bezerra Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  • Leonardo Martins Pires Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  • Luís Carlos Amon Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  • Marina Bergamini Blaya Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  • Rafael Selbach Scheffel Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

Palavras-chave:

hemorrhage, stroke, atrial fibrillation, warfarin, phenprocoumon

Resumo

Background. The use of risk scores for the assessment of major bleeding and stroke in patients with atrial fibrillation (AF) helps evaluate the risks and benefits of oral anticoagulation therapy. The aim of this study was to describe the percentage of  patients receiving anticoagulants for non-valvular AF with a high risk of major bleeding based on the HAS-BLED score, as well as identify potential modifiable risk factors of bleeding and compare the risk of major bleeding with the risk of stroke.

Methods. Retrospective cohort study involving patients of the anticoagulation outpatient clinic of the Division of Internal Medicine at Hospital de Clínicas de Porto Alegre. Major bleeding risk was estimated based on the HAS-BLED score and stroke risk was determined using the CHADS2 and CHA2DS2-VASc scores.

Results. Sixty-three patients were investigated (mean age 74.3±10.9 years). The median HAS-BLED score was 2 points, 19 (30.2%) patients had a score ≥ 3 (high risk). The most prevalent modifiable risk factors were labile TP/INR (36.5%) and concomitant use of drugs (30.2%). The absolute risk of major bleeding based on the HAS-BLED score was higher than the risk of stroke in three (4.8%) and four (6.3%) patients in comparison with the CHADS2 and CHA2DS2-VASc score, respectively.

Conclusions. We concluded that the percentage of patients with high risk of major bleeding is similar to the rate found in the national literature (30.2%). In addition, the most prevalent modifiable risk factors in our cohort were labile TP/INR and concomitant drug use. 

 

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Publicado

2015-07-03

Como Citar

1.
Pivatto Júnior F, da Silva ALF, Bezerra IV, Pires LM, Amon LC, Blaya MB, Scheffel RS. Major bleeding risk assessment in atrial fibrillation patients taking vitamin K antagonists. Clin Biomed Res [Internet]. 3º de julho de 2015 [citado 4º de dezembro de 2022];35(2). Disponível em: https://seer.ufrgs.br/index.php/hcpa/article/view/54273

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