{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T23:10:52Z","timestamp":1777331452731,"version":"3.51.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,11,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.<\/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\">\n              This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry. The primary end point was the incidence of bleeding. Patients were categorized based on their DOAC Score: low and moderate\u2010 (\u22647 points), high\u2010 (8\u20139 points), and very high\u2010risk (\u226510 points) groups. Among 1230 patients (mean age 84.6\u00b15.1\u2009years; 457 men), 465 (37.8%) received a vitamin K antagonist, and the remaining patients received DOACs. The low and moderate\u2010, high\u2010, and very high\u2010risk groups included 380 (30.1%), 497 (40.4%), and 353 patients (28.7%), respectively. The 3\u2010year cumulative incidence of all bleeding events was significantly different among the 3 groups (low and moderate risk: 6.6%, high risk: 6.9%, and very high risk: 14.0%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). Multivariable Cox regression analysis revealed that significant increments in the DOAC Score were associated with a risk of all bleeding events at 3\u2009years in the overall cohort (hazard ratio [HR], 1.22 [95% CI, 1.08\u20131.38];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), in the DOAC cohort (HR, 1.20 [95% CI, 1.01\u20131.42];\n              <jats:italic>P<\/jats:italic>\n              =0.04), and in the vitamin K antagonist cohort (HR, 1.25 [95% CI, 1.04\u20131.50];\n              <jats:italic>P<\/jats:italic>\n              =0.02).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The DOAC Score was significantly associated with bleeding events in patients with atrial fibrillation after transcatheter aortic valve replacement, aiding in clinical decision\u2010making for anticoagulant management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/center6.umin.ac.jp\/cgi-open-bin\/ctr_e\/ctr_view.cgi?recptno=R000023585\">https:\/\/center6.umin.ac.jp\/cgi\u2010open\u2010bin\/ctr_e\/ctr_view.cgi?recptno=R000023585<\/jats:ext-link>\n              ; Unique identifier: UMIN000020423.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036417","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T10:18:02Z","timestamp":1730974682000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6724-3782","authenticated-orcid":false,"given":"Yoshihiro","family":"Harano","sequence":"first","affiliation":[{"name":"Department of Cardiology Gifu Heart Center Gifu Japan"},{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-6382","authenticated-orcid":false,"given":"Masanori","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology Gifu Heart Center Gifu Japan"},{"name":"Department of Cardiology Toyohashi Heart Center Toyohashi Japan"},{"name":"Department of Cardiology Nagoya Heart Center Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Shimura","sequence":"additional","affiliation":[{"name":"Department of Cardiology Gifu Heart Center Gifu 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