{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T18:52:53Z","timestamp":1772823173994,"version":"3.50.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Bayer Hispania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Assessing bleeding risk during the decision-making process of starting oral anticoagulation (OAC) therapy in atrial fibrillation (AF) patients is essential. Several bleeding risk scores have been proposed for vitamin K antagonist users but, few studies have focused on validation of these bleeding risk scores in patients taking direct oral anticoagulants (DOACs). The aim was to compare the predictive ability of HAS-BLED and ORBIT bleeding risk scores in AF patients taking rivaroxaban in the EMIR (\u2018Estudio observacional para la identificaci\u00f3n de los factores de riesgo asociados a eventos cardiovasculares mayores en pacientes con fibrilaci\u00f3n auricular no valvular tratados con un anticoagulante oral directo [Rivaroxaban]) Study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>EMIR Study was an observational, multicenter, post-authorization, and prospective study that involved AF patients under OAC with rivaroxaban at least 6 months before enrolment. We analysed baseline clinical characteristics and adverse events after 2.5 years of follow-up and validated the predictive ability of HAS-BLED and ORBIT scores for major bleeding (MB) events.<\/jats:p>\n                  <jats:p>We analysed 1433 patients with mean age of 74.2\u00a0\u00b1\u00a09.7 (44.5% female). Mean HAS-BLED score was 1.6\u00a0\u00b1\u00a01.0 and ORBIT score was 1.1\u00a0\u00b1\u00a01.2. The ORBIT score categorised a higher proportion of patients as \u2018low-risk\u2019 (87.1%) compared with 53.5% using the HAS-BLED score. There were 33 MB events (1.04%\/year) and 87 patients died (2.73%\/year). Both HAS-BLED and ORBIT had a good predictive ability for MB{Area under the curve (AUC) 0.770, [95% confidence interval (CI) 0.693\u20130.847; P\u00a0&amp;lt;0.001] and AUC 0.765 (95% CI 0.672\u20130.858; P\u00a0&amp;lt;0.001), respectively}. There was a non-significant difference for discriminative ability of the two tested scores (P\u00a0=\u00a00.930) and risk reclassification in terms of net reclassification improvement (NRI) \u22125.7 (95% CI \u221242.4\u201331.1; P\u00a0=\u00a00.762). HAS-BLED score showed the best calibration and ORBIT score showed the largest mismatch in calibration, particularly in higher predicted risk patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In a prospective real-world AF population under rivaroxaban from EMIR registry, the HAS-BLED score had good predictive performance and calibration compared with ORBIT score for MB events. ORBIT score presented worse calibration than HAS-BLED in this DOAC treated population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvac060","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T16:17:58Z","timestamp":1667319478000},"page":"38-46","source":"Crossref","is-referenced-by-count":15,"title":["Predicting performance of the HAS-BLED and ORBIT bleeding risk scores in patients with atrial fibrillation treated with Rivaroxaban: Observations from the prospective EMIR Registry"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3104-3460","authenticated-orcid":false,"given":"Mar\u00eda A","family":"Esteve-Pastor","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca), CIBERCV , 30120 Murcia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 M","family":"Rivera-Caravaca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca), CIBERCV , 30120 Murcia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Hematology and Clinical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, IMIB-Arrixaca , 30008 Murcia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Sanmartin Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Ramon y Cajal , 28034 Madrid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Arribas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario 12 de Octubre; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM); Instituto de Investigacion Sanitaria Hospital 12 de Octubre (IMAS 12); CIBERCV , 28041 Madrid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Masjuan","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Ram\u00f3n y Cajal, Madrid. Alcal\u00e1 University , 28034 Madrid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivencio","family":"Barrios","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Ram\u00f3n y Cajal, Madrid. Alcal\u00e1 University , 28034 Madrid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Cosin-Sales","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Arnau de Vilanova , 46015 Valencia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rom\u00e1n","family":"Freixa-Pamias","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Mois\u00e9s Broggi , 08970 Barcelona , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Recalde","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Basurto , 48013 Bilbao , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro I","family":"P\u00e9rez-Cabeza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Virgen de la Victoria, CIBERCV , 29010 M\u00e1laga , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Manuel V\u00e1zquez Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario A Coru\u00f1a, INIBIC, CIBERCV, 15006 A Coru\u00f1a , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carles","family":"R\u00e0fols Priu","sequence":"additional","affiliation":[{"name":"Department of Medical Affairs, Bayer Hispania , 08970 Barcelona , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Anguita S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Reina Sof\u00eda C\u00f3rdoba, IMIBIC, University of Cordoba , 14004 C\u00f3rdoba , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital , L69 7TX Liverpool , UK"},{"name":"Department of Clinical Medicine, Aalborg University , 9000 Aalborg , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-7708","authenticated-orcid":false,"given":"Francisco","family":"Marin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca), CIBERCV , 30120 Murcia , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,11,1]]},"reference":[{"issue":"5","key":"2022121510272342700_bib1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the 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