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Finally, in conclusion, all clinicians – especially primary care physicians, who may become the principal caregivers for these patients with AFib in the era of NOACs – should be familiar with one of many bleeding scores that have been published. The Figure shows the well-known HAS-BLED scoring algorthm, which includes patients who have hypertension, abnormal renal or liver function, bleeding history, predisposition or labile INR, elderly patients who are frail or >65 years, or with a history of concomitant drugs/alcohol use. Knowing the bleeding score for patients at high risk will ensure more intelligent decision-making as to how to manage patients needing both antiplatelet and antithrombin therapy, whether the decision is to go with single, dual, or triple therapy to manage patients who have both AFib and underlying CAD/ACS problems.
French WJ. Am J Med 2013; 126: 00-00.
[HAS-BLED = Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly]