ArticleJournal of the American Heart Association2025
Development and Validation of Dynamic Prediction Model for Thromboembolic and Bleeding Risk in Patients With Atrial Fibrillation Initiating Direct Oral Anticoagulants.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- DOAC Score Versus HAS-BLED and ORBIT for Predicting Bleeding Events in Atrial Fibrillation on Direct Oral Anticoagulants.Clinical cardiology · 2026Pooled it
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent tools for assessing ischemic stroke and bleeding risks in patients with atrial fibrillation focus on warfarin users and initial therapy decisions; however, dynamic models for reassessing these risks in direct oral anticoagulant (DOAC) users are lacking. We aimed to develop a tool that enables the dynamic evaluation of thromboembolic and bleeding risks in patients with atrial fibrillation receiving DOAC therapy.
methodsUsing a national claims database, we included 42 450 patients with atrial fibrillation who were newly prescribed DOACs and divided them into development (2018) and temporal-validation (2019) cohorts. We applied a landmarking approach and developed dynamic prediction models incorporating time-dependent variables. The Fine-Gray subdistribution hazard model, which accounts for death as a competing risk, was used to derive these models.
resultsDynamic prediction models incorporating time-dependent variables, such as DOAC adherence, were developed to estimate the 1-year thromboembolic and major bleeding risks over a 2-year period following DOAC initiation. The thromboembolic and major bleeding risk prediction models achieved a concordance index of 0.715 (95% CI, 0.701-0.729), and 0.697 (95% CI, 0.682-0.710), respectively. The thromboembolic model outperformed CHA
conclusionsThese dynamic prediction models offer a novel approach for reassessing thromboembolic and major bleeding risks in patients with atrial fibrillation receiving DOACs, demonstrating superior performance compared with existing models. Enabling regular risk updates based on the patient's current status, these tools support personalized and dynamic risk assessments in clinical practice.
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