title: Bleeding Risk Profile in Patients With Symptomatic Peripheral Artery Disease.
abstract: OBJECTIVE
  To assess the bleeding risk profile using the HAS-BLED score in patients with symptomatic peripheral artery disease (PAD).
  
  
  METHODS
  A post hoc analysis was performed using data from a series of 115 consecutive patients (mean age 72.4±11.4 years; 68 men) with symptomatic PAD undergoing endovascular revascularization. The endpoint of the study was to assess bleeding risk using the 9-point HAS-BLED score, which was previously validated in cohorts of patients with and without atrial fibrillation. For the purpose of this study, the low (0-1), intermediate (2), and high-risk (≥3) scores were stratified as low/intermediate risk (HAS-BLED <3) vs high risk (HAS-BLED ≥3).
  
  
  RESULTS
  The mean HAS-BLED score was 2.76±1.16; 64 (56%) patients had a HAS-BLED score ≥3.0. Patients with PAD Rutherford category 5/6 ischemia had an even higher mean HAS-BLED score (3.20±1.12). Logistic regression analysis revealed aortoiliac or femoropopliteal segment involvement, chronic kidney disease, as well as Rutherford category 5/6, to be independent risk factors associated with a HAS-BLED score ≥3.
  
  
  CONCLUSIONS
  Patients with PAD, especially those presenting with Rutherford category 5/6 ischemic symptoms, have high HAS-BLED scores, suggesting increased risk for major bleeding. Prospective clinical validation of the HAS-BLED score in patients with PAD may help with the risk-benefit assessment when prescribing antithrombotic therapy.
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, FL, USA.
authors.forename: Frederic
authors.initials: F
authors.lastname: Baumann
authors.affiliation: Clinic for Angiology, University Hospital of Zurich and University of Zurich, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Husmann
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, FL, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Benenati
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, FL, USA.
authors.forename: Barry T
authors.initials: BT
authors.lastname: Katzen
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, FL, USA iand@baptisthealth.net.
authors.forename: Ian
authors.initials: I
authors.lastname: Del Conde
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D011237:Predictive Value of Tests; D036301:Qualitative Research; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: HAS-BLED score; antithrombotic therapy; aortoiliac segment; bleeding; femoropopliteal segment; peripheral artery disease