Risk factor | Points | |
---|---|---|
Maximum score is 9, since the age provides 1 or 2 points. The recommendation on selecting antithrombotic therapy based on the score is displayed in image 1. The risk factors marked with red colour cannot be affected, but the risk associated with other factors can be reduced by good management of these. * Earlier myocardial infarction, coronary artery disease, aortic arch plaque or severe periferal arterial disease 1 In this modified version of the score, female sex gives one point only if age is HASH(0x2f82cc8) 75 years, allowing the use of identical cut-off values for both men and women. | ||
Congestive heart failure | 1 | |
Hypertension | 1 | |
A2ge HASH(0x2f82cc8) 75 years | 2 | |
Diabetes | 1 | |
Earlier S2troke or TIA | 2 | |
Vascular disease* | 1 | |
Age 65-74 years | 1 | |
Sex category female, when age HASH(0x2f82cc8) 75 years | 1 |
Risk factor | Points | |
---|---|---|
The risk factors marked with red colour cannot be affected, but the risk associated with other factors can be reduced in most cases by good management of these. Bleeding risk is increased if the total score is at least 3. * Cancer, anaemia, thrombocytopenia, platelet dysfunction, earlier bleeding | ||
Hypertension | over 160 mmHg | 1 |
Abnormal liver or kidney function | Severe failure of liver or kidneys | 1 for each |
Stroke | Earlier stroke | 1 |
Bleeding | Bleeding diathesis * | 1 |
Labile INR | Fluctuation of INR values | 1 |
Elderly | Age over 65 years | 1 |
Drugs or alcohol | Medication that increases bleeding risk or abundant use of alcohol | 1 for each |
Benefits |
---|
Fewer intracranial haemorrhages |
Constant dosage and easier to predict dose-effect relationship |
Variation in vitamin K intake (nutrition) does not change the effect |
Fewer drug interactions |
No need for routine monitoring of drug effect (easier and more convenient to implement) |
Significant disadvantages |
Contraindicated in patients with mitral stenosis and in patients with mechanical prosthetic valve |
Contraindicated in patients with severe renal failure (dosage can be reduced in milder cases) |
Other aspects to consider |
Poorer availability of monitoring methods (follow-up of drug effect and compliance is more challenging when it is needed) |
Patient's age and weight influence the dosage of some preparations |
Other adverse effects than bleeding are more common (e.g. dyspepsia) |
Price |
Shorter experience of use |