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.

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1. Anemia?

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