Objective: To compare the predictive value of HAS-BLED, HEMORR2HAGES, ATRIA and ORBIT scores on the
bleeding risk in nonvalvular
atrial fibrillation (NVAF) patients treated with
dabigatran. Methods: Data of 942 NVAF patients participating a non-interventional prospective study of
anticoagulant therapy with
dabigatran, which was conducted in 12 centers from February 2015 to December 2017 in China, were analyzed. Complete HAS-BLED HEMORR2HAGES, ATRIA and ORBIT
bleeding risk scores data and follow-up data were available in the enrolled patients. The endpoint of the study was
bleeding events occurred during a 6 months follow-up. Cox proportional hazards models were constructed to analyze the associations between HAS-BLED, HEMORR2HAGES, ATRIA and ORBIT scores and risk of
bleeding, and the area under the curve (AUC) of receiver operating characteristics curves (ROC) of each score was used to set the predictive value for
bleeding risk. Results: Among the 942 patients, the mean age was (65.3±11.2) years old, 542 (57.5%) were males. A total of 93 (9.9%)
bleeding events occurred during follow up, 89 (9.4%) events were minor
bleeding, and 4 (0.4%) events were major
bleeding. Patients with a high-risk HAS-BLED score had a 1.87-fold increased risk of
bleeding compared with low-risk patients (HR = 2.87, 95% CI:1.26-6.51, P = 0.012). There was no statistically significant difference between low-medium-high-risk grading in other scoring systems and
bleeding risk (all P>0.05). The AUC (95%CI) of HAS-BLED, HEMORR2HAGES, ATRIA and ORBIT
bleeding risk scores were 0.558 (0.525-0.590), 0.520 (0.487-0.553), 0.513(0.480-0.545), 0.523(0.490-0.555), respectively. The AUC of all
bleeding score systems were of ≤ 0.700. Conclusion: Among the NVAF patients taking
dabigatran in China, the HAS-BLED
bleeding risk score is superior to other 3
bleeding risk score on predicting the
bleeding risk in these patients, but its predictive value is still relatively low.