title: Impact of the HAS-BLED Score on Long-Term Outcomes After Percutaneous Coronary Intervention.
abstract: Percutaneous coronary intervention (PCI) has become an established treatment for coronary artery disease. In patients receiving a drug-eluting stent (DES), dual antiplatelet therapy (DAPT) is recommended for at least 12 months. However, DAPT is a risk factor for bleeding, and risk stratification for bleeding is very important for patients with an implanted DES. The HAS-BLED score has been proposed as a practical tool to assess the bleeding risk of patients with atrial fibrillation. The aims of the study were to assess whether the HAS-BLED score has predictive value for major bleeding and survival in patients after PCI using a DES. A total of 2,171 patients were treated by PCI from 2004 to 2011 at our institution. Of these, 1,207 consecutive patients with an implanted DES were analyzed. The patients were classified into 2 groups based on the HAS-BLED score (high ≥3, low 0 to 2). The primary outcome was major bleeding and death. There were several severe co-morbidities in the high HAS-BLED score group compared with the low group. The median follow-up period was 3.6 years (interquartile range 1.5 to 5.4 years). The incidence of both death and major bleeding was higher in the high HAS-BLED score group than in the low HAS-BLED score group. On multivariate Cox proportional hazards regression analysis, high HAS-BLED score was associated with both death and major bleeding. In conclusion, the HAS-BLED score could predict the risk of bleeding and mortality for patients who underwent PCI independent of the presence of atrial fibrillation.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: ktmmy@med.juntendo.ac.jp.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Isoda
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants