Evidence map›Paper›PMID 37840634›Full record

ArticleJournal of geriatric cardiology : JGC2023

Predictive value of bleeding risk scores in elderly patients with atrial fibrillation and oral anticoagulation.

Pablo Domínguez-Erquicia, Sergio Raposeiras-Roubín, Emad Abu-Assi, Andrea Lizancos-Castro, Jose A Parada-Barcia, André González-García, Ana Ledo-Piñeiro, Vanesa Noriega-Caro, Carla Iglesias-Otero, Andrés Íñiguez-Romo

Registry-linked trialOpen access · bronzeAbstract read
In one paragraph

Article in Journal of geriatric cardiology : JGC, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04364516 (Retrospective Observational Registry of Patients With Atrial Fibrillation From Vigo´s Health Area), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04364516 unknown statusnot on this map

Retrospective Observational Registry of Patients With Atrial Fibrillation From Vigo´s Health Area (Registro Observacional Retrospectivo de Pacientes Con Fibrilación Auricular Del Área de Vigo)

TypeobservationalSponsorHospital Álvaro CunqueiroRan2018 to 2023Enrolled15,000ConditionsAtrial FibrillationArmsAnticoagulation
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Pablo Domínguez-ErquiciaDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Sergio Raposeiras-RoubínDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Emad Abu-AssiDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Andrea Lizancos-CastroDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Jose A Parada-BarciaDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
André González-GarcíaDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Ana Ledo-PiñeiroDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Vanesa Noriega-CaroDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Carla Iglesias-OteroDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
Andrés Íñiguez-RomoDepartment of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain.
University Hospital Complex Of Vigo · ESGalicia Sur Biomedical Foundation · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe predictive value of bleeding risk scores for atrial fibrillation in older patients is not as well known. The goal of this study was to evaluate the predictive value of HASBLED, ORBIT and ATRIA for major bleeding (MB) and intracranial hemorrhage (ICH) in patients ≥ 75 years with atrial fibrillation and oral anticoagulation (OAC).

methodsA retrospective unicenter study including patients ≥ 75 years with atrial fibrillation (AF) and OAC. A total of 7613 patients ≥ 75 years with AF and OAC included between 2014 and 2018 (registry: NCT04364516). We analyzed the discriminative value of HASBLED, ATRIA and ORBIT scores for bleeding endpoints (major bleeding as primary endpoint and intracerebral hemorrhage as secondary). Cox regression was used to predict major bleeding with each scale and also for searching other variables potentially predictor of major bleeding. Model discrimination was assessed using Harrell's C-statistic. Calibration was assessed with goodness-of-fit test proposed by Gronnesby and Borgan.

resultsDuring a mean follow up of 4.0 years (IQR: 2.4-5.7 years), 729 patients developed MB (2.61 per 100 patients/year) and 243 patients developed ICH (0.85 per 100 patients/year). Three scores showed a low discrimination for major bleeding, being ORBIT the best (HASBLED C statistic = 0.557; ATRIA C statistic = 0.568; ORBIT C statistic = 0.595) and also a low discrimination for ICH (HASBLED C statistic = 0.509; ATRIA C statistic = 0.522; ORBIT C statistic = 0.526). Among the variables that are part of the scores and other baseline characteristics, after multivariable adjustment only sex (male), dementia, prior admission for bleeding, anemia and liver disease were found as a predictors of MB.

conclusionsIn older patients under oral anticoagulation with atrial fibrillation, the risk scores HASBLED, ATRIA and ORBIT showed a weak discrimination for major bleeding and intracranial hemorrhage. Therefore, other better alternatives should be evaluated for this purpose.

Identifiers

PMID37840634
PMCPMC10568544
OpenAlexW4387604484

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.