Arrhythmias & electrophysiologyDiagnostic or prognostic study
DOAC score among patients receiving Vitamin K antagonists
- external validation of a bleeding risk score in a pooled clinical trials cohort and a registry
Authors' conclusion
In patients with atrial fibrillation taking VKAs, the DOAC score was able to risk stratify patients based on bleeding risk, had moderate discrimination, and out-performed the HAS-BLED score in both a pooled clinical trials cohort and a usual care registry.
Study context
- Population
- Patients with atrial fibrillation receiving vitamin K antagonistspatients receiving vitamin K antagonists, per cohort · COMBINE-AF 28,818 · GARFIELD-AF 20,183
- Comparison
- DOAC score discrimination compared with HAS-BLED using DeLong's test
Performance
As reported in the abstract
Major bleeding event, COMBINE-AF · 1 year
Patients with major bleeding, COMBINE-AF
994 (3.4%)
Further findings
| Outcome | Values | C-statistic | P value |
|---|---|---|---|
| Major bleeding rate by DOAC score risk category, COMBINE-AF · 1 year | very low 1.8 events per 100 person-years · low 3.0 events/100 p-y · moderate 4.6 events/100 p-y · high 5.6 events/100 p-y · very high 7.9 events/100 p-y | ||
| Discrimination, COMBINE-AF · 1 year · moderate and higher than HAS-BLED | 0.62 vs 0.59 | P < 0.001 | |
| Major bleeding rate by DOAC score risk category, GARFIELD-AF · 1 year | very low 0.8 events per 100 person-years · low 1.5 events/100 p-y · moderate 2.2 events/100 p-y · high 3.2 events/100 p-y · very high 7.6 events/100 p-y | ||
| Discrimination, GARFIELD-AF · 1 year · moderate and higher than the HAS-BLED score | 0.65 vs 0.62 | P < 0.001 |
Major bleeding event, GARFIELD-AF · 1 year
- Patients with major bleeding, GARFIELD-AF
- 313 (1.6%)
Original publication
DOAC score among patients receiving Vitamin K antagonists. Am Heart J. Published 23 June 2026. doi:10.1016/j.ahj.2026.107520
Summarised from the published abstract; every number is checked against it