Various bleeding risk scores have been proposed to assess the risk of bleeding inatrial fibrillation (AF) patients undergoing anticoagulation. PRECISE DAPTscore has been developed to assess the out-of hospital bleeding risk inpatients receiving dual antiplatelet therapy (DAPT). Our objective was to comparethe predictive performance between the HAS-BLED (Hypertension, AbnormalRenal/Liver Function, Stroke, Bleeding History or Predisposition, LabileInternational Normalized Ratio, Elderly, Drugs/Alcohol), ATRIA (Anticoagulationand Risk Factors in Atrial Fibrillation), and PRECISE-DAPT (Predicting BleedingComplication in Patients Undergoing Stent Implantation and Subsequent DualAntiplatelet therapy) score in AF patients using antiplatelet agents or anticoagulants.

We recruited 1,114consecutive AF patients (51% male; median age, 71 years) receiving antiplateletagents or oral anticoagulants from January 2014 through December 2018. The HAS-BLED, ATRIA, and PRECISE-DAPT bleeding risk scores were calculated from patients’ clinical characteristics. Majorbleeding was defined as according to the Bleeding Academic Research Consortium(BARC) criteria (type 3 or 5: hemodynamic instability, need for transfusion,drop in hemoglobin ≥ 3 g, and intracranial, intraocular or fatal bleeding). Theperformance of risk scores were assessed by C-statistic.

Bleeding events occurred in  72 patients (6.5%) from 30 days till1-year follow-up. Based on the C-statistic, PRECISE-DAPT score (AUC: 0.70, 95%CI: 0.67-0.72) and ATRIA score (AUC: 0.69, 95% CI: 0.66-0.72) had a good performance, significantly better than HAS-BLED (AUC:0.64, 95% CI: 0.61-0.67) (p = 0.03). And, PRECISE-DAPT score was similar to ATRIA score in predicting bleeding events.

All 3 bleeding risk scores demonstrated onlymodest performance in predicting 12-month bleedings in Korean AF patientsreceiving antiplatelet agents or oral anticoagulant (warfain or NOAC), althoughthe predictive ability of HAS-BLED score was not superior to ATRIA, andPRECISE-DAPT scores. PRECISE-DAPT score for DAPT can be used as bleeding riskscore in AF patients with HAS-BLED, ATRIA and PRECISE-DAPT score.