老年房颤患者抗凝治疗的安全性策略()90115精编PPT课件.pptVIP

SOURCE GIVEN IN ORIGINAL SLIDE SET: Apostolakis S, Lane DA, Guo Y, Buller H, Lip GY. J Am Coll Cardiol. 2012 Jul 24. [Epub ahead of print] PMID: Am Coll Cardiol.?2012 Jul 24. [Epub ahead of print] Performance of the HEMORR(2)HAGES, ATRIA, and HAS-BLED Bleeding Risk-Prediction Scores in Patients With Atrial Fibrillation Undergoing Anticoagulation: The AMADEUS (Evaluating the Use of SR34006 Compared to Warfarin or Acenocoumarol in Patients With Atrial Fibrillation) Study. Apostolakis S,?Lane DA,?Guo Y,?Buller H,?Lip GY. Source University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. OBJECTIVES:The objective of this study was to compare the predictive performance of bleeding risk-estimation tools in a cohort of patients with atrial fibrillation (AF) undergoing anticoagulation. BACKGROUND:Three bleeding risk-prediction schemes have been derived for and validated in patients with AF: HEMORR(2)HAGES (Hepatic or Renal Disease, Ethanol Abuse, Malignancy, Older Age, Reduced Platelet Count or Function, Re-Bleeding, Hypertension, Anemia, Genetic Factors, Excessive Fall Risk and Stroke), ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), and HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly, Drugs/Alcohol). Τhe relative predictive values of these bleeding scores have not previously been compared. METHODS:We analyzed the dataset from the AMADEUS (Evaluating the Use of SR34006 Compared to Warfarin or Acenocoumarol in Patients With Atrial Fibrillation) trial, a multicenter, randomized, open-label noninferiority study that compared fixed-dose idraparinux with adjustable-dose oral vitamin K antagonist therapy in patients with AF. The principal safety outcome was any clinically relevant bleeding event, which was a composite of major bleeding plus clinically relevant nonmajor bleeding. RESULTS:The HAS-BLED score performe