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Brain & Heart Digital tools for stroke and bleeding risk in AF (Cont’d...)

DOAC (2023) 10 ≥65 years old History eGFR≤60 mL/min History or major or minor bleeding event AST, ALT, ALP≥3 × ULN, ALP≥2 × ULN, or Cirrhosis Includes TIA and/or systemic embolism Current ✔ BMI <18.5 kg/m^2 Current

GARFIELD‑AF (2017) 8 ✔ CKD III-IV ✔ ✔ ✔

eGFR <60 mg/dL/1.73 m^2 Hb <13 mg/dL or Hct <40% in Men; Hb <12 mg/dL or Hct <36% in Women

Table 2. Factors used in various scoring systems for assessing bleeding risk in patients with atrial fibrillation (AF)

ORBIT (2015) 5 ≥75 years old ✔ ✔

ATRIA (2011) 5 ≥75 years old ✔ eGFR <30 mL/ min or dialysis-dependent ✔ (3) Hb <13 g/dL in Men; Hb <12 g/dL in Women

>160 mmHg systolic blood Dialysis, transplant, Cr >2.26 mg/dL or >200 µmol/L ✔ (Included within the factor Cirrhosis or bilirubin >2 × normal with AST/ALT/AP Unstable/high INRs, time in therapeutic range <60% ✔ (Included in the category medications predisposing to ✔ (Included in the category medications predisposing to

HAS‑BLED (2010) 9 >65 years old Uncontrolled, pressure ✔ (2) bleeding history) >3 × normal ≥8 drinks/week Particularly lacunar bleeding) bleeding)

HEMORR 2 HAGES (2006) 11 >75 years old Uncontrolled ESRD or creatinine >2.5 mg/dL ✔ ✔ End-stage liver disease or cirrhosis ✔ ✔ ✔ Thrombocytopenia and blood dyscrasias (Hemophilia) High risk of falling, dementia, Parkinson’s or psychiatric disease CYP 2C9 single-nucleotide polymorphisms Aspirin use

Number of variables Diagnosed hypertension Bleeding history Hepatic disease Prior stroke or TIA Reduced platelet counts Excessive fall risk Genetic factors Treatment with Diabetes mellitus

Factors Old age Renal disease Anemia Alcohol excess Malignancy or function Labile INR antiplatelets Underweight NSAID use

Volume 2 Issue 3 (2024) 8 doi: 10.36922/bh.3068