Abstract 13929: Clinical Usefulness of HAS-BLED Score to Predict Cardiovascular Outcome in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention with Stenting

Abstract

Backgruond: Oral anticoagulant therapy (OAC) with dual antiplatelet therapy increases the risk of hemorrhagic complications in patients with AF undergoing percutaneous coronary intervention (PCI) with stenting. The HAS-BLED score (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile PT-INR [international normalized ratio], elderly, drugs/alcohol concomitantly) has simply assessed the risk of major bleeding in patients with AF and OAC. However, the relation between HAS-BLED score and major adverse cardiac events (MACE) remains unclear in AF patients after PCI. We investigated whether the HAS-BLED score could predict MACE in patients with AF undergoing PCI with stenting.

Methods and Results: We studied 177 consecutive patients (74.0% men, mean age 73±9 yrs) with AF undergoing PCI with stenting. We evaluated clinical data and laboratory findings, and obtained HAS-BLED score. The median value of HAS-BLED score was 2 (range, 0-5), and 69 (39%) of 177 patients had a score ≥ 3 (high risk group). During the follow-up period of 1123±544 days, 38 patients had major bleeding events and 53 patients had MACE. There were no significant differences in baseline clinical characteristic and the content of used OAC between patients with and without HAS-BLED score ≥ 3. Kaplan-Meier analysis revealed that major bleeding events and MACE were significantly frequently observed in patients with than without HAS-BLED score ≥ 3 (major bleeding events: 33% vs 14%, p<0.0001; MACE: 38% vs 25%, p=0.003). The HAS-BLED score was significantly associated with major bleeding events (HR, 3.14; 95% CI, 1.47-6.49) and MACE (HR, 1.81; 95% CI, 1.02-3.49).

Conclusion: HAS-BLED score might be useful for predicting not only major bleeding events, but also MACE in patients with AF undergoing PCI with stenting.