We have located links that may give you full text access.
Development and Validation of a Bleeding Risk Prediction Score for Patients with Mitral Valve Stenosis and Atrial Fibrillation or Mechanical Heart Valves Receiving Long-term Warfarin Therapy.
British Journal of Clinical Pharmacology 2022 September 22
AIM: This study aimed to develop and validate a new bleeding risk score to predict warfarin-associated major bleeding for patients with mitral valve stenosis with atrial fibrillation (MSAF) or mechanical heart valves (MHV).
METHODS: A multi-center, retrospective cohort study was conducted at three hospitals in Thailand. Adult patients with MSAF or MHV receiving warfarin for > 3 months during 2011-2015 were identified. Data collection and case validation were performed electronically and manually. Potential variables were screened using the Least Absolute Shrinkage and Selection Operator (LASSO). Multivariate logistic regression analysis using stepwise backward selection was used to construct a risk score. Predictive discrimination of the score was evaluated using the C-statistic. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test.
RESULTS: There were 1,287 patients (3,903.41 patient-year of follow-up) with 192 patients experiencing bleeding (4.92 event/100 patient-year) in the derivation cohort. A new bleeding risk score termed, the HEARTS-60+3 score (Hypertension/History of bleeding; External factors e.g., alcohol/drugs [aspirin or NSAIDs]; Anemia/hypoalbuminemia; Renal/hepatic insufficiency; Time in therapeutic range of <60%; Stroke; age > 60 years; Target international normalized ratio or INR of 3.0 [2.5-3.5]), was developed and showed good predictive performance (C-statistic [95%CI] of 0.88 [0.85-0.91]). In the external validation cohort of 832 patients (2,018.45 patient-year with a bleeding rate of 4.31 event/100 patient-year), the HEARTS-60+3 score showed a good predictive performance with a C-statistic [95%CI] of 0.84 [0.81-0.89]).
CONCLUSION: The HEARTS-60+3 score shows a potential as a bleeding risk prediction score in MSAF or MHV patients.
METHODS: A multi-center, retrospective cohort study was conducted at three hospitals in Thailand. Adult patients with MSAF or MHV receiving warfarin for > 3 months during 2011-2015 were identified. Data collection and case validation were performed electronically and manually. Potential variables were screened using the Least Absolute Shrinkage and Selection Operator (LASSO). Multivariate logistic regression analysis using stepwise backward selection was used to construct a risk score. Predictive discrimination of the score was evaluated using the C-statistic. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test.
RESULTS: There were 1,287 patients (3,903.41 patient-year of follow-up) with 192 patients experiencing bleeding (4.92 event/100 patient-year) in the derivation cohort. A new bleeding risk score termed, the HEARTS-60+3 score (Hypertension/History of bleeding; External factors e.g., alcohol/drugs [aspirin or NSAIDs]; Anemia/hypoalbuminemia; Renal/hepatic insufficiency; Time in therapeutic range of <60%; Stroke; age > 60 years; Target international normalized ratio or INR of 3.0 [2.5-3.5]), was developed and showed good predictive performance (C-statistic [95%CI] of 0.88 [0.85-0.91]). In the external validation cohort of 832 patients (2,018.45 patient-year with a bleeding rate of 4.31 event/100 patient-year), the HEARTS-60+3 score showed a good predictive performance with a C-statistic [95%CI] of 0.84 [0.81-0.89]).
CONCLUSION: The HEARTS-60+3 score shows a potential as a bleeding risk prediction score in MSAF or MHV patients.
Full text links
Related Resources
Trending Papers
Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows.Endocrine Reviews 2024 April 28
The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association.Circulation 2024 April 26
Intravenous infusion of dexmedetomidine during the surgery to prevent postoperative delirium and postoperative cognitive dysfunction undergoing non-cardiac surgery: a meta-analysis of randomized controlled trials.European Journal of Medical Research 2024 April 19
Interstitial Lung Disease: A Review.JAMA 2024 April 23
Ventilator Waveforms May Give Clues to Expiratory Muscle Activity.American Journal of Respiratory and Critical Care Medicine 2024 April 25
Acute Kidney Injury and Electrolyte Imbalances Caused by Dapagliflozin Short-Term Use.Pharmaceuticals 2024 March 27
Systemic lupus erythematosus.Lancet 2024 April 18
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app