The ABC Bleeding risk score

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The ABC (Age, Biomarkers, Clinical history) bleeding risk score has been developed to predict the risk of bleeding in patients with atrial fibrillation. The ABC bleeding risk score is internally and externally validated using two clinical trial databases.

This model is intended to be used for patients who have been diagnosed with either paroxysmal, persistent or permanent atrial fibrillation or atrial flutter and with at least one or more of the risk factors. The full inclusion and exclusion criteria are stated in the intended use.

Research authors: Ziad Hijazi, Jonas Oldgren, Johan Lindbäck, John H Alexander, Stuart J Connolly, John W Eikelboom, Michael D Ezekowitz, Claes Held, Elaine M Hylek, Renato D Lopes, Agneta Siegbahn, Salim Yusuf, Christopher B Granger, Lars Wallentin, ARISTOTLE and RE-LY Investigators

Version: 2.5

Public
Cardiology
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V-2.5-2326.23.10.10

(01)08720299526433(8012)v2.5(4326)231010(240)2326

Download the User manual and consult the Intended purpose.

Details
Intended purpose
Electronic label
Release Notes
User manual

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The calculated bleeding risk is:

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The calculated bleeding risk is: %

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Conditional information

The current model calculates the risk of bleeding occurring within the next one, two, or three years. Even though the tool may support decision involving the initiation of anticoagulant treatment, a high bleeding risk alone should not immediately lead to withholding anticoagulation.

The ABC bleeding risk score was externally validated and compared head-to-head with similar prediction models such as the HAS-BLED score. The external validation of the ABC score resulted in a c-index of 0.69 (95% CI: 0.66 - 0.71) versus 0.62 (95% CI: 0.60 - 0.64) for the HAS-BLED score.

Depending on the selected biomarker, the model may perform slightly different. Still, all possible combinations of biomarkers resulted in similar model performance in terms of discrimination with C-indexes ranging between 0.68 and 0.71 on internal validation. Each of the six ABC bleeding risk score models performed better than the HAS-BLED score.

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Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

Underlying models Part of

Additional information

Details

Model author

T. A. Hueting

Model ID

10301

Version

2.5

Revision date

2023-10-10

Specialty

Cardiology

Model type

R-Script model ^{(Calculation)}

MeSH terms

Bleeding

Atrial Fibrillation

Status

Public

Formula
No Formula defined yet

Condition	Formula

Study characteristics

Additional information

The ABC Bleeding risk score was developed using data from two trials. Data from the ARISTOTLE trial, and the RE-LY trial were used.

The data shown here concern the characteristics of the ARISTOTLE trial, which was used as derivation cohort.

The ABC Bleeding risk score has been developed and validated by Hijazi et al. and was externally validated and compared to the HAS-BLED score by Berg et al. The ABC-bleeding score outperformed the HAS-BLED score in the external validation studies

To further assess the impact of the ABC risk models, a trial is currently ongoing (NCT03753490)

Study Population

Total population size: 14537

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Continuous characteristics

Name	Mean	Unit
Age	70	years
Renal function (CKD-EPI)	74.1	mL/min
Cystatin C	1	mg/L
GDF-15	1381	ng/L
Troponin T	10.9	ng/L
Troponin I	5.4	ng/L
Haemoglobin	14.2	g/dL
Haematocrit	43	%
NT-proBNP	711	ng/L

Categorical characteristics

Name	Subset / Group	Nr. of patients
Alcohol consumption	No	14171
Alcohol consumption	Yes	366
Antiplatelet or NSAIDs	No	8928
Antiplatelet or NSAIDs	Yes	5609
Current smoker	No	13361
Current smoker	Yes	1176
Diabetes	No	10935
Diabetes	Yes	3602
Hypertension	No	1820
Hypertension	Yes	12717
Congestive heart failure	No	10023
Congestive heart failure	Yes	4514
Permanent or persistent atrial fi brillation	No	2214
Permanent or persistent atrial fi brillation	Yes	12323
Previous bleeding	No	12164
Previous bleeding	Yes	2373
Previous stroke	No	11794
Previous stroke	Yes	2743
Previous myocardial infarction	No	12669
Previous myocardial infarction	Yes	1868
Previous peripheral vascular disease	No	13825
Previous peripheral vascular disease	Yes	712
Vascular disease	No	10920
Vascular disease	Yes	3617

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V-2.5-2326.23.10.10

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The calculated bleeding risk is: %

Conditional information

Details

Study characteristics

Additional information

Study Population

Continuous characteristics

Categorical characteristics

Supporting Publications

Related files

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	Evidencio B.V., Irenesingel 19, 7481 GJ Haaksbergen, The Netherlands
	V-2.5-2326.23.10.10
	(01)08720299526433(8012)v2.5(4326)231010(240)2326
	Download the User manual
	Medical device