Validation of CHA₂DS₂-VASc and HAS-BLED Scores in Japanese Patients With Nonvalvular Atrial Fibrillation : An Analysis of the J-RHYTHM Registry

• Okumura Ken

  Department of Cardiology, Hirosaki University Graduate School of Medicine

• Inoue Hiroshi

  Second Department of Internal Medicine, University of Toyama School of Medicine

• Atarashi Hirotsugu

  Department of Cardiology, Nippon Medical School Tama-Nagayama Hospital

• Yamashita Takeshi

  Cardiovascular Institute Hospital

• Tomita Hirofumi

  Department of Cardiology, Hirosaki University Graduate School of Medicine

• Origasa Hideki

  Division of Biostatistics and Clinical Epidemiology, University of Toyama School of Medicine

• for the J-RHYTHM Registry Investigators.

書誌事項

タイトル別名

• Validation of CHA₂DS₂-VASc and HAS-BLED Scores in Japanese Patients With Nonvalvular Atrial Fibrillation
• Validation of CHS2DS2-VASc and HAS-BLED scores in Japanese patients with nonvalvular atrial fibrillation
• Validation of CHA2DS2-VASc and HAS-BLED scores in Japanese patients with nonvalvular atrial fibrillation
• – An Analysis of the J-RHYTHM Registry –

抄録

Background: Recent European guidelines recommended the CHA₂DS₂-VASc score for thromboembolic and the HAS-BLED score for bleeding risk stratifications. We validated these scores in 7,384 Japanese patients with nonvalvular atrial fibrillation (NVAF) enrolled in the J-RHYTHM Registry. Methods and Results: Of the study cohort, 6,387 patients taking warfarin and the other 997 not taking warfarin were prospectively examined for 2 years. Thromboembolic and major bleeding risks were stratified by modified CHA₂DS₂-VASc (mCHA₂DS₂-VASc) and HAS-BLED (mHAS-BLED) scores, respectively. Of the patients with mCHA₂DS₂-VASc score 0, 1, and ≥2, thromboembolism occurred in 2/141 (0.7%/year), 4/233 (0.9%/year), and 24/623 (1.9%/year), respectively, in the non-warfarin group, and in 1/346 (0.1%/year, P=0.19 vs. non-warfarin), 4/912 (0.2%/year, P=0.05), and 92/5,129 (0.9%/year, P=0.0005), respectively, in the warfarin group. When female sex was excluded from the score, thromboembolism occurred in 2/180 patients (0.6%/year), 5/245 (1.0%/year), and 23/572 (1.6%/year), respectively, in the non-warfarin group, and in 1/422 (0.1%/year, P=0.20 vs. non-warfarin), 5/1,096 (0.2%/year, P=0.02), and 91/4,869 (0.9%/year, P=0.0005), respectively, in the warfarin group. Patients with mHAS-BLED scores ≥3 were at high risk for major bleeding irrespective of warfarin treatment (1.3 and 2.6%/year in the non-warfarin and warfarin groups, respectively). Conclusions: In Japanese NVAF patients, the mCHA₂DS₂-VASc score is useful for identifying patients at truly low risk of thromboembolism. Female sex may be excluded as a risk from the score. mHAS-BLED score ≥3 is useful for identifying patients at high risk of major bleeding.  (Circ J 2014; 78: 1593–1599)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 78 (7), 1593-1599, 2014

  一般社団法人 日本循環器学会

キーワード

• Atrial fibrillation
• CHA₂DS₂-VASc
• HAS-BLED
• Major bleeding
• Thromboembolism

詳細情報

• CRID: 1390001205106387584
• NII論文ID: 130003391135
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-14-0144
• COI: 1:STN:280:DC%2BC2cnmtFGksQ%3D%3D
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 025533542
• PubMed: 24759791
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I025533542
• Web Site: https://www.jstage.jst.go.jp/article/circj/78/7/78_CJ-14-0144/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2015132856
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
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