{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T19:06:12Z","timestamp":1775761572927,"version":"3.50.1"},"reference-count":33,"publisher":"Elsevier BV","issue":"23","license":[{"start":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T00:00:00Z","timestamp":1385856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T00:00:00Z","timestamp":1385856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T00:00:00Z","timestamp":1418169600000},"content-version":"vor","delay-in-days":374,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100009664","name":"Sociedad Espa\u00f1ola de Cardiolog\u00eda","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009664","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"ISCIII","doi-asserted-by":"crossref","award":["RD06\/0014\/039"],"award-info":[{"award-number":["RD06\/0014\/039"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"ISCIII","doi-asserted-by":"crossref","award":["PI11\/1256-FEDER"],"award-info":[{"award-number":["PI11\/1256-FEDER"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American College of Cardiology"],"published-print":{"date-parts":[[2013,12]]},"DOI":"10.1016\/j.jacc.2013.08.1623","type":"journal-article","created":{"date-parts":[[2013,9,18]],"date-time":"2013-09-18T16:20:16Z","timestamp":1379521216000},"page":"2199-2204","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":166,"title":["The HAS-BLED Score Has Better Prediction Accuracy for Major Bleeding Than CHADS2 or CHA2DS2-VASc Scores in Anticoagulated Patients With Atrial Fibrillation"],"prefix":"10.1016","volume":"62","author":[{"given":"Vanessa","family":"Rold\u00e1n","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Mar\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Manzano-Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Gallego","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Antonio","family":"V\u00edlchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariano","family":"Vald\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente","family":"Vicente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacc.2013.08.1623_bib1","doi-asserted-by":"crossref","first-page":"857","DOI":"10.7326\/0003-4819-146-12-200706190-00007","article-title":"Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation","volume":"146","author":"Hart","year":"2007","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jacc.2013.08.1623_bib2","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1093\/eurheartj\/ehs435","article-title":"Stroke and bleeding risk assessment in atrial fibrillation: when, how, and why?","volume":"34","author":"Lip","year":"2013","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2013.08.1623_bib3","doi-asserted-by":"crossref","first-page":"2864","DOI":"10.1001\/jama.285.22.2864","article-title":"Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation","volume":"285","author":"Gage","year":"2001","journal-title":"JAMA"},{"key":"10.1016\/j.jacc.2013.08.1623_bib4","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1378\/chest.09-1584","article-title":"Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation","volume":"137","author":"Lip","year":"2010","journal-title":"Chest"},{"key":"10.1016\/j.jacc.2013.08.1623_bib5","doi-asserted-by":"crossref","first-page":"2719","DOI":"10.1093\/eurheartj\/ehs253","article-title":"2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association","volume":"33","author":"Camm","year":"2012","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2013.08.1623_bib6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.thromres.2007.05.014","article-title":"Risk of bleeding in very old atrial fibrillation patients on warfarin: relationship with ageing and CHADS2 score","volume":"121","author":"Poli","year":"2007","journal-title":"Thromb Res"},{"key":"10.1016\/j.jacc.2013.08.1623_bib7","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.1161\/CIRCULATIONAHA.106.653048","article-title":"Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation","volume":"115","author":"Hylek","year":"2007","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2013.08.1623_bib8","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1160\/TH11-02-0070","article-title":"Impact of the type of centre on management of AF patients: surprising evidence for differences in antithrombotic therapy decisions","volume":"105","author":"Kirchhof","year":"2011","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib9","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1160\/TH11-11-0768","article-title":"Oral anticoagulation use by patients with atrial fibrillation in Germany. Adherence to guidelines, causes of anticoagulation under-use and its clinical outcomes, based on claims-data of 183,448 patients","volume":"107","author":"Wilke","year":"2012","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib10","doi-asserted-by":"crossref","first-page":"e710","DOI":"10.3399\/bjgp12X656856","article-title":"Risk of stroke and oral anticoagulant use in atrial fibrillation: a cross-sectional survey","volume":"62","author":"Holt","year":"2012","journal-title":"Br J Gen Pract"},{"key":"10.1016\/j.jacc.2013.08.1623_bib11","unstructured":"MIMS Malaysia: Full prescribing information of Pradaxa. http:\/\/www.mims.com.my\/MALAYSIA\/drug\/info\/Pradaxa\/?type=full#SpecialPrecautions. Accessed March 6,\u00a02013."},{"key":"10.1016\/j.jacc.2013.08.1623_bib12","unstructured":"Pradaxa Prescribing Information, Taiwan Food and Drug. Available at: Administration. http:\/\/www.fda.gov.tw\/MLMS\/(S(nmvmo245foj0qw55kb0ae4bi))\/ShowFile.aspx?LicId=02025458&Seq=002&Type=9. Accessed March 6, 2013."},{"key":"10.1016\/j.jacc.2013.08.1623_bib13","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1160\/TH11-10-0690","article-title":"Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis","volume":"106","author":"Lip","year":"2011","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib14","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1378\/chest.10-0134","article-title":"A\u00a0novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey","volume":"138","author":"Pisters","year":"2010","journal-title":"Chest"},{"key":"10.1016\/j.jacc.2013.08.1623_bib15","first-page":"125","article-title":"Focused 2012 update of the Canadian Cardiovascular Society atrial fibrillation guidelines: recommendations for stroke prevention and rate\/rhythm control","volume":"28","author":"Skanes","year":"2012","journal-title":"Can J Cardiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib16","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.jacc.2012.10.010","article-title":"Performance of the HEMORR(2)HAGES, ATRIA, and HAS-BLED bleeding risk-prediction scores in non-warfarin anticoagulated atrial fibrillation patients","volume":"61","author":"Apostolakis","year":"2013","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib17","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1378\/chest.12-0608","article-title":"Predictive value of the HAS-BLED and ATRIA bleeding scores for the risk of serious bleeding in a \u201creal-world\u201d population with atrial fibrillation receiving anticoagulant therapy","volume":"143","author":"Roldan","year":"2013","journal-title":"Chest"},{"key":"10.1016\/j.jacc.2013.08.1623_bib18","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1161\/CIRCEP.112.972869","article-title":"Assessing the risk of bleeding in patients with atrial fibrillation: the Loire Valley Atrial Fibrillation project","volume":"5","author":"Lip","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib19","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1016\/j.ijcard.2012.12.076","article-title":"Comparative assessment of the HAS-BLED score with other published bleeding risk scoring schemes for intracranial haemorrhage risk in a non-atrial fibrillation population: The Chin-Shan Community Cohort Study","volume":"168","author":"Lip","year":"2013","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1160\/TH11-12-0827","article-title":"The HAS-BLED score predicts bleeding during bridging of chronic oral anticoagulation. Results from the national multicentre BNK Online bRiDging REgistRy (BORDER)","volume":"108","author":"Omran","year":"2012","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib21","doi-asserted-by":"crossref","first-page":"672","DOI":"10.4244\/EIJV8I6A105","article-title":"Triple antithrombotic therapy following an acute coronary syndrome: prevalence, outcomes and prognostic utility of the HAS-BLED score","volume":"8","author":"Smith","year":"2012","journal-title":"EuroIntervention"},{"key":"10.1016\/j.jacc.2013.08.1623_bib22","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1161\/CIRCINTERVENTIONS.112.968792","article-title":"Should we recommend oral anticoagulation therapy in patients with atrial fibrillation undergoing coronary artery stenting with a high HAS-BLED bleeding risk score?","volume":"5","author":"Ruiz-Nodar","year":"2012","journal-title":"Circ Cardiovasc Interv"},{"key":"10.1016\/j.jacc.2013.08.1623_bib23","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2005.01204.x","article-title":"Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients","volume":"3","author":"Schulman","year":"2005","journal-title":"J\u00a0Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib24","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/sim.2929","article-title":"Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond","volume":"27","author":"Pencina","year":"2008","journal-title":"Stat Med"},{"key":"10.1016\/j.jacc.2013.08.1623_bib25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","article-title":"The meaning and use of the area under a receiver operating characteristic (ROC) curve","volume":"143","author":"Hanley","year":"1982","journal-title":"Radiology"},{"key":"10.1016\/j.jacc.2013.08.1623_bib26","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1148\/radiology.148.3.6878708","article-title":"A\u00a0method of comparing the areas under receiver operating characteristic curves derived from the same cases","volume":"148","author":"Hanley","year":"1983","journal-title":"Radiology"},{"key":"10.1016\/j.jacc.2013.08.1623_bib27","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jacc.2010.09.024","volume":"57","author":"Lip","year":"2011","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib28","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1111\/j.1538-7836.2011.04378.x","article-title":"Bleeding risk in \u2018real world' patients with atrial fibrillation: comparison of two established bleeding prediction schemes in a nationwide cohort","volume":"9","author":"Olesen","year":"2011","journal-title":"J\u00a0Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib29","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/qjmed\/hcm076","article-title":"Risk factors for anticoagulation-related bleeding complications in patients with atrial fibrillation: a systematic review","volume":"100","author":"Hughes","year":"2007","journal-title":"QJM"},{"key":"10.1016\/j.jacc.2013.08.1623_bib30","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1161\/CIRCEP.111.967000","article-title":"Relation of the HAS-BLED bleeding risk score to major bleeding, cardiovascular events and mortality in anticoagulated patients with atrial fibrillation","volume":"5","author":"Gallego","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib31","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.recesp.2012.02.017","article-title":"Predictive value of the CHA(2)DS(2)-VASc Score in atrial \ufb01brillation patients at high risk for stroke despite oral anticoagulation","volume":"65","author":"Jover","year":"2012","journal-title":"Rev Esp Cardiol"},{"key":"10.1016\/j.jacc.2013.08.1623_bib32","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1160\/TH10-07-0491","article-title":"New-onset atrial fibrillation and\u00a0warfarin initiation: high risk periods and implications for new anti-thrombotic drugs","volume":"104","author":"Garc\u00eda","year":"2010","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jacc.2013.08.1623_bib33","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1161\/CIRCOUTCOMES.108.796185","article-title":"Anticoagulation control and prediction of adverse events in patients with atrial fibrillation: a systematic review","volume":"1","author":"Wan","year":"2008","journal-title":"Circ Cardiovasc Qual Outcomes"}],"container-title":["Journal of the American College of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735109713051632?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735109713051632?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:04:01Z","timestamp":1760015041000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0735109713051632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12]]},"references-count":33,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["S0735109713051632"],"URL":"https:\/\/doi.org\/10.1016\/j.jacc.2013.08.1623","relation":{},"ISSN":["0735-1097"],"issn-type":[{"value":"0735-1097","type":"print"}],"subject":[],"published":{"date-parts":[[2013,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The HAS-BLED Score Has Better Prediction Accuracy for Major Bleeding Than CHADS2 or CHA2DS2-VASc Scores in Anticoagulated Patients With Atrial Fibrillation","name":"articletitle","label":"Article Title"},{"value":"Journal of the American College of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacc.2013.08.1623","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}