Bleeding risk assessment in patients with atrial fibrillation who are taking oral anticoagulants.
Research article published in Hospital practice (1995) (2013)
Abstract
Prevention of thromboembolism is the key priority in the management of patients with atrial fibrillation (AF). Clinical decisions on antithrombotic management should be based on the balance between an individual's thromboembolic and hemorrhagic risk. The HAS-BLED score is a simple and user-friendly tool for the assessment of bleeding risk. It is recommended for bleeding risk assessment by the 2010 European Society of Cardiology guidelines for the management of AF, and the latest guidelines of the Canadian Cardiovascular Society for the prevention of stroke and systemic thromboembolism in patients with AF and atrial flutter. A HAS-BLED score ≥ 3 indicates high risk for hemorrhage and suggests that modifiable risk factors affecting bleeding (eg, blood pressure, hepatic/renal function, international normalized ratio, antiplatelet agents, and nonsteroidal anti-inflammatory drugs) be reviewed and corrected. Patients at high risk for stroke (CHA2DS2-VASc score ≥ 2) and hemorrhage (HAS-BLED score ≥ 3) seem to gain significant benefit from oral anticoagulants. As a general rule, oral anticoagulants should be considered for all patients with AF, except those at very low risk for stroke (CHA2DS2-VASc score of 0) and those at extremely high risk for bleeding. The newer oral anticoagulants (eg, dabigatran, rivaroxaban, and apixaban) are promising alternatives to vitamin K antagonists for the prevention of stroke in patients with nonvalvular AF.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Bleeding risk assessment in patients with atrial fibrillation who are taking oral anticoagulants.
Por qué esto importa para la hirudoterapia
Esta revisión analiza la evaluación del riesgo hemorrágico mediante la escala HAS-BLED en pacientes con fibrilación auricular que toman anticoagulantes orales, recomendando que los pacientes de alto riesgo corrijan los factores de riesgo hemorrágico modificables y señalando que los anticoagulantes orales más nuevos (dabigatrán, rivaroxabán, apixabán) son alternativas prometedoras a los antagonistas de la vitamina K. El resumen no contiene ninguna mención de sanguijuelas, hirudoterapia, hirudina ni compuestos derivados de sanguijuela. Si bien el dabigatrán es un inhibidor directo de la trombina relacionado mecanísticamente con la hirudina, el enfoque del artículo es puramente sobre el manejo farmacéutico de anticoagulantes, sin ofrecer relevancia directa para el ámbito de la ASH.
Citación
Bleeding risk assessment in patients with atrial fibrillation who are taking oral anticoagulants.
Guo et al. · Hospital practice (1995), 2013
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026