Raposeiras-Roubin et al reported a score for predicting bleeding risk in a patient started on antithrombotic therapy started for acute coronary syndrome (ACS). This can help to identify a patient who may require closer monitoring. The authors are from multiple institutions from around the world.
Patient selection: acute coronary syndrome, started on dual antiplatelet therapy (DAPT)
Parameters:
(1) age in years
(2) hypertension
(3) vascular disease
(4) history of bleeding
(5) malignancy
(6) serum creatinine in mg/dL
(7) hemoglobin in g/dL
Parameter
Finding
Points
age in years
< 67 years
0
67 to 74.9 years
7
>= 75 years
9
hypertension
no
0
yes
7
vascular disease
no
0
yes
6
history of bleeding
no
0
yes
19
malignancy
no
0
yes
8
serum creatinine
< 1.0 mg/dL
0
1 to 1.49 mg/dL
3
>= 1.5 mg/dL
12
hemoglobin
< 11 g/dL
18
11 to 13.9 g/dL
9
>= 14 g/dL
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 79
Score
Risk Group
0 to 7
very low
8 to 16
low
17 to 25
moderate
>= 26
high
Performance:
• The area under the ROC curve varied from 0.63 to 0.71 depending on the study cohort.
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