Arrhythmias & electrophysiology
Major Bleeding Risk Assessment With Atrial Fibrillation Post-TAVR: The HARHP Score Results From ENVISAGE-TAVI Atrial Fibrillation (AF)
Authors' conclusion
Five independent predictors of long-term MB were identified in patients with AF requiring oral anticoagulant agents after TAVR and formed the HARHP score to assess MB risk.
Study context
- Population
- Patients with AF after successful transcatheter aortic valve replacement (TAVR)
- Participants
- 1,377 patients
- Comparison
- HARHP risk categories: high vs low and moderate risk
- Primary endpoint
- Major bleeding (MB)
Methodological detailson-treatment analysis, risk score derivation
- On-treatment analysis
- Risk score derivation
Primary result
As reported in the abstract
MB by HARHP risk category
Hazard ratio (95% CI)P value
High riskvs Low risk
6.54(3.61–11.85)
P < 0.0001High riskvs Moderate risk
2.86(1.62–5.04)
P = 0.0003- Patients with major bleeding (MB)
- 139 (10.1%)
- Mean ± SD on-treatment follow-up
- 1.3 ± 0.8 years
Further findings
HARHP score discrimination (C statistic)
- C statistic at 1-year follow-up
- 0.63
- C statistic at 2-year follow-up
- 0.62
Original publication
Major Bleeding Risk Assessment With Atrial Fibrillation Post-TAVR: The HARHP Score Results From ENVISAGE-TAVI AF. JACC Cardiovasc Interv. Published 9 February 2026. doi:10. 1016/ j. jcin. 2025. 11. 028
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