Bleeding Risk in Atrial Fibrillation: ATRIA
Estimate bleeding risk for patients on warfarin.
The ATRIA study was done to develop a risk stratification score to predict bleeding with warfarin.
The population studied had non-valvular, persistent atrial fibrillation
Major hemorrhage was defined as bleed that was fatal, required transfusion of ≥ 2 units blood, or hemorrhage into a critical anatomic site (intracranial, retroperitoneal, etc).
The following risk factors, along with their point value were determined as follows:
- Anemia +3
- Severe Renal Disease/Dialysis +3
- Age ≥ 75 +2
- Stroke History +1
- Prior Hemorrhage +1
- Hypertension +1
Risk of major hemorrhage was determined based on total score:
- <4 points - low risk (<1%)
- 4 points - intermediate risk (2.6%)
- *>4 points - high risk (5.8%)
Studies that compared the performance of the ATRIA and HAS-BLED bleeding risk-prediction scores showed that HAS-BLED had better accuracy than ATRIA.
Fang MC, Go AS, Chang Y, et al.
Roldán V et al.