Abstract

A SYSTEMATIC REVIEW ON EVALUATING BLEEDING RISK IN PATIENTS RECEIVING ACENOCOUMAROL TREATMENT

D. Ann Suji, Divya Marin Philip*, Merwin Frederick, K. Srinivasu and K. Dhivya

ABSTRACT

Acenocoumarol is an effective oral anticoagulant. Even though it is effective, there is significant bleeding risk due to its narrow therapeutic index. The aim of the study is to determine the risk of major bleeding using the HAS-BLED and HEMORR2HAGES and to compare the predictive performance of bleeding risk–estimation tools in patients receiving acenocoumarol reported in studies. We systematically searched the Cochrane Library and PubMed electronic databases for studies reporting the HAS-BLED and HEMORR2HAGES scores for predicting the bleeding risk associated with acenocoumarol. Four eligible studies were included. The predictive performance of HASBLED for bleeding outcomes were better than HEMORR2HAGES, as reflected by c-index 0.7. Hence, HEMORR2HAGES score failed to demonstrate a significant predictive value for major bleeding. Results suggest that when comparing HASBLED with HEMORR2HAGES, the former has better prediction ability for low and high bleeding risk in patients receiving acenocoumarol treatment, according to the included studies report.

Keywords: Acenocoumarol, bleeding risk assessment, HAS-BLED, HEMORR2HAGES, systematic review.