Is the ORBIT Bleeding Risk Score Superior to the HAS-BLED Score in Anticoagulated Atrial Fibrillation Patients?
Por:
Esteve-Pastor, MA, Garcia-Fernandez, A, Macias, M, Sogorb, F, Valdes, M, Roldan, V, Muniz, J, Badimon, L, Roldan, I, Bertomeu-Martinez, V, Cequier, A, Lip, GYH, Anguita, M, Marin, F
Publicada:
1 oct 2016
Resumen:
Background: Several bleeding risk scores have been validated in patients with atrial fibrillation (AF). The ORBIT score has been recently proposed as a simple score with the best ability to predict major bleeding. The present study aimed to test the hypothesis that the ORBIT score was superior to the HAS-BLED score for predicting major bleeding and death in "real world" anticoagulated AF patients.
Methods and Results: We analyzed the predictive performance for bleeding and death of 406 AF patients who underwent 571 electrical cardioversion procedures and 1,276 patients with permanent/persistent AF from the FANTASIIA registry. In the cardioversion population, 21 patients had major bleeding events and 26 patients died. The predictive performance for major bleeding of HAS-BLED and ORBIT were not significantly different (c-statistics 0.77 (95% CI 0.66-0.88) and 0.82 (95% CI 0.77-0.93), respectively; P=0.080). For the FANTASIIA population, 46 patients had major bleeding events and 50 patients died. The predictive performances for major bleeding of HASBLED and ORBIT were not significantly different (c-statistics 0.63 (95% CI 0.56-0.71) and 0.70 (95% CI 0.62-0.77), respectively; P=0.116). For death, the predictive performances of HAS-BLED and ORBIT were not significantly different in both populations. The ORBIT score categorized most patients as "low risk".
Conclusions: Despite the original claims in its derivation paper, the ORBIT score was not superior to HAS-BLED for predicting major bleeding and death in a "real world" oral anticoagulated AF population.
Filiaciones:
Esteve-Pastor, MA:
IMIB Arrixaca, Hosp Univ Virgen de la Arrixaca, Dept Cardiol, Murcia, Spain
Garcia-Fernandez, A:
ISABIAL FISABIO Fdn, Inst Hlth & Biomed Res, Hosp Gen Univ Alicante, Dept Cardiol, Alicante, Spain
Macias, M:
ISABIAL FISABIO Fdn, Inst Hlth & Biomed Res, Hosp Gen Univ Alicante, Dept Cardiol, Alicante, Spain
Sogorb, F:
ISABIAL FISABIO Fdn, Inst Hlth & Biomed Res, Hosp Gen Univ Alicante, Dept Cardiol, Alicante, Spain
Valdes, M:
IMIB Arrixaca, Hosp Univ Virgen de la Arrixaca, Dept Cardiol, Murcia, Spain
Roldan, V:
Hosp Morales Meseguer, Dept Hematol, Murcia, Spain
Muniz, J:
Hosp Univ A Coruna, Dept Cardiol, La Coruna, Spain
Badimon, L:
IIB St Pau, Hosp Santa Creu & St Pau, CSICICCC, Cardiovasc Res Ctr, Barcelona, Spain
Roldan, I:
Hosp La Paz, Dept Cardiol, Madrid, Spain
Bertomeu-Martinez, V:
Hosp Univ San Juan, Dept Cardiol, Alicante, Spain
Cequier, A:
Bellvitge Hosp, Dept Cardiol, Barcelona, Spain
Lip, GYH:
Univ Birmingham, Inst Cardiovasc Sci, City Hosp, Birmingham, W Midlands, England
Anguita, M:
Hosp Univ Reina Sofia, Dept Cardiol, Cordoba, Spain
Marin, F:
IMIB Arrixaca, Hosp Univ Virgen de la Arrixaca, Dept Cardiol, Murcia, Spain
Bronze, Green Published
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