Percutaneous coronary intervention (PCI) has become an established treatment for coronary artery disease. In patients receiving a drug-eluting stent (DES), dual antiplatelet therapy (DAPT) is recommended for at least 12 months. However, DAPT is a risk factor for bleeding, and risk stratification for bleeding is very important for patients with an implanted DES. The HAS-BLED score has been proposed as a practical tool to assess the bleeding risk of patients with atrial fibrillation. The aims of the study were to assess whether the HAS-BLED score has predictive value for major bleeding and survival in patients after PCI using a DES. A total of 2,171 patients were treated by PCI from 2004 to 2011 at our institution. Of these, 1,207 consecutive patients with an implanted DES were analyzed. The patients were classified into 2 groups based on the HAS-BLED score (high ≥3, low 0 to 2). The primary outcome was major bleeding and death. There were several severe co-morbidities in the high HAS-BLED score group compared with the low group. The median follow-up period was 3.6 years (interquartile range 1.5 to 5.4 years). The incidence of both death and major bleeding was higher in the high HAS-BLED score group than in the low HAS-BLED score group. On multivariate Cox proportional hazards regression analysis, high HAS-BLED score was associated with both death and major bleeding. In conclusion, the HAS-BLED score could predict the risk of bleeding and mortality for patients who underwent PCI independent of the presence of atrial fibrillation.
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