{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:13:20Z","timestamp":1783462400680,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,12,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The association between cancer types and specific bleeding events in patients with atrial fibrillation has been scarcely investigated. Also, the performance of bleeding risk scores in this high\u2010risk subgroup of patients is unclear. We investigated the rate of any bleeding, intracranial hemorrhage, major bleeding, and gastrointestinal bleeding according to cancer types in patients with atrial fibrillation. We also tested the predictive value of HAS\u2010BLED, ATRIA, and ORBIT bleeding risk scores.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Observational retrospective cohort study including hospitalized patients with atrial fibrillation and cancer from the French National Hospital Discharge Database (Programme de Medicalisation des Systemes d'Information) from January 2010 to December 2019. Major bleeding was defined according to Bleeding Academic Research Consortium definitions. Patients with HAS\u2010BLED \u22653, ATRIA \u22655, or ORBIT \u22654 were classified as at high bleeding risk. Receiver operating characteristic analysis for each score against any bleeding, major bleeding, gastrointestinal bleeding, and intracranial hemorrhage was performed. Areas under the curve (AUCs) were then compared. We included 399\u2009344 patients. Mean age was 77.9\u00b110.2\u2009years, and 63.2% were men. The highest intracranial hemorrhage rates were found in leukemia (1.89%\/year), myeloma (1.52%\/year), lymphoma and liver (1.45%\/year), and pancreas cancer (1.41%\/year). Receiver operating characteristic analysis showed that ORBIT score predicted best for any bleeding. In addition, ORBIT score \u22654 had the highest predictivity for major bleeding (AUC, 0.805), followed by HAS\u2010BLED \u22653 and ATRIA \u22655 (AUCs, 0.716 and 0.700, respectively). HAS\u2010BLED and ORBIT performed best for intracranial hemorrhage (AUCs, 0.744 and 0.742 for continuous scores, respectively), better than ATRIA (AUC, 0.635). For gastrointestinal bleeding, ORBIT \u22654 had the highest predictivity (AUC, 0.756), followed by the HAS\u2010BLED \u22653 (AUC, 0.702) and ATRIA \u22655 (AUC, 0.662).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Some cancer types carry a greater bleeding risk in patients with atrial fibrillation. The identification and management of modifiable bleeding risk factors is crucial in these patients, as well as to flag up high bleeding risk patients for early review and follow\u2010up.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.026388","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T11:12:57Z","timestamp":1669720377000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Performance of the HAS\u2010BLED, ORBIT, and ATRIA Bleeding Risk Scores on a Cohort of 399\u2009344 Hospitalized Patients With Atrial Fibrillation and Cancer: Data From the French National Hospital Discharge Database"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-5213","authenticated-orcid":false,"given":"Daniele","family":"Pastori","sequence":"first","affiliation":[{"name":"Emergency Medicine Unit \u2010 Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences Sapienza University of Rome Rome Italy"},{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, United Kingdom Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5400-6980","authenticated-orcid":false,"given":"Am\u00e9lie","family":"Marang","sequence":"additional","affiliation":[{"name":"Service de Cardiologie Centre Hospitalier Universitaire Trousseau et EA7505, Facult\u00e9 de M\u00e9decine, Universit\u00e9 Fran\u00e7ois Rabelais Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-1800","authenticated-orcid":false,"given":"Arnaud","family":"Bisson","sequence":"additional","affiliation":[{"name":"Service de Cardiologie Centre Hospitalier Universitaire Trousseau et EA7505, Facult\u00e9 de M\u00e9decine, Universit\u00e9 Fran\u00e7ois Rabelais Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Herbert","sequence":"additional","affiliation":[{"name":"Service de Cardiologie Centre Hospitalier Universitaire Trousseau et EA7505, Facult\u00e9 de M\u00e9decine, Universit\u00e9 Fran\u00e7ois Rabelais Tours France"},{"name":"Service d\u2019information m\u00e9dicale, d\u2019\u00e9pid\u00e9miologie et d\u2019\u00e9conomie de la sant\u00e9 Centre Hospitalier Universitaire et EA7505, Facult\u00e9 de M\u00e9decine, Universit\u00e9 Fran\u00e7ois Rabelais Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Yoke Hong","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, United Kingdom 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