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CC BY 4.0 · Thromb Haemost
DOI: 10.1055/a-2642-0241
Stroke, Systemic or Venous Thromboembolism

Performance of Bleeding Risk Scores for Major Bleeding in Anticoagulated Patients with Pulmonary Embolism: Insights from the CURES Registry-2

Yuzhi Tao
1   Department of Pulmonary and Critical Care Medicine, The First Bethune Hospital of Jilin University, Jilin University, Changchun, China
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Hong Chen
5   Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
,
Chunling Dong
6   Department of Pulmonary and Critical Care Medicine, The Second Hospital, Jilin University, Changchun, China
,
Jie Zhang
6   Department of Pulmonary and Critical Care Medicine, The Second Hospital, Jilin University, Changchun, China
,
Yiwei Shi
7   Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, China
,
Xiaomao Xu
8   Department of Pulmonary and Critical Care Medicine, Beijing Hospital, Beijing, China
,
Maoyun Wang
9   Department of Pulmonary and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
,
Ling Zhu
10   Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
,
Juhong Shi
11   Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China
,
Yingqun Ji
12   Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Shanghai, China
,
Hong Chen
13   Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
,
Zhe Cheng
14   Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
,
Yongjun Tang
15   Department of Pulmonary and Critical Care Medicine, Xiangya Hospital Central South University, Changsha, China
,
Yanxia Li
16   Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
,
Chaosheng Deng
17   Department of Pulmonary and Critical Care Medicine, The first affiliated Hospital of Fujian Medical University, Fuzhou, China
,
Qin Luo
18   Department of Pulmonary and Critical Care Medicine, The Third Clinical Medical College of Xinjiang Medical University, Urumqi, China
,
Pinyao Lu
19   Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Chengde Medical university, Chengde, China
,
Yuanhua Yang
20   Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
,
Linfeng Xi
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
21   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China
,
Yu Zhang
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Rui Liang
22   Beijing University of Chinese Medicine China-Japan Friendship School of Clinical Medicine, Beijing, China
,
Dingyi Wang
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Guohui Fan
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Wanmu Xie
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Jun Wan
23   Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Zhu Zhang
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Shuai Zhang
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Yunxia Zhang
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Qiang Huang
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Qian Gao
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Min Liu
24   Department of Radiology, China-Japan Friendship Hospital, Beijing, China
,
Peiran Yang
25   Department of Physiology, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
,
Shengfeng Wang
26   Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
27   Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
,
Chen Wang
1   Department of Pulmonary and Critical Care Medicine, The First Bethune Hospital of Jilin University, Jilin University, Changchun, China
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
Zhenguo Zhai
2   National Centre for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Centre for Respiratory Diseases, Beijing, China
3   Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
4   Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
,
on behalf of the CURES investigators› Author Affiliations
Funding The Fund of the National Key Research and Development Program of China (grant number 2023YFC2507200); the CAMS Innovation Fund for Medical Sciences (CIFMS) (grant numbers 2021-I2M-1-061, 2021-I2M-1-049); the National High Level Hospital Clinical Research Funding (grant number 2022-NHLHCRF-LX-01); and the National Natural Science Foundation of China (No. 82241029).
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Abstract

Background

Most bleeding risk scores for pulmonary embolism (PE) were developed in patients receiving traditional anticoagulants. Evidence in East Asian populations and its applicability to direct oral anticoagulants (DOACs) remain limited.

Methods

This post-hoc analysis was based on a multicentre, prospective study (NCT02943343) conducted from 2016 to 2021. The predictive performance of bleeding risk scores was assessed using a time-dependent area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and decision curve analysis (DCA). Propensity score matching (PSM) was adjusted for baseline characteristics. We analyzed the impact of initial DOAC versus low-molecular-weight heparin (LMWH) on outcomes. The endpoint was major bleeding (MB) within 90 days and composite outcomes (all-cause mortality, recurrent VTE, and MB).

Results

Of 7,619 patients with PE, 1.4% (107 patients) experienced MB within 90 days. The RIETE score showed a modest predictive ability (AUC: 0.70; 95% CI, 0.65–0.75) for predicting 90-day MB and demonstrated a predictive advantage in the DCA results. NRI also revealed significantly better reclassification capability than the other scores, except for HAS-BLED. Among low-risk patients classified by the RIETE score, initial DOAC treatment significantly reduced 14-day composite outcomes compared with LMWH (HR = 0.13; 95% CI, 0.02–0.93). Furthermore, DOACs at discharge did not increase the risk of MB or composite outcomes.

Conclusion

RIETE score shows modest performance in predicting MB and identifying low bleeding risk in PE patients, which could potentially guide early DOAC use. Further studies are needed to test its clinical utility, especially in East Asian populations.

Keywords

pulmonary embolism - anticoagulation - major bleeding - score - prediction

Data Availability Statement

The data underlying this article cannot be shared publicly due to ethical reasons. The data will be shared on reasonable request to the corresponding author.


Authors' Contribution

Concept and design: Y.T., H.C., C.D., J.Z., Y.S., X.X., C.W., and Z.Z.; acquisition, analysis, or interpretation of data: all authors; drafting of the manuscript: Y.T., H.C., C.D., M.W., L.Z., L.X., Y.Z., C.W., and Z.Z.; critical review of the manuscript for important intellectual content: all authors; statistical analysis: Y.T., J.S., Y.J., H.C., Z.C., Y.T., L.R., D.W., G.F., and S.W.; obtained funding: C.W. and Z.Z.; administrative, technical, or material support: Y.L., C.D., Q.L., P.L., Y.Y., C.W., and Z.Z.; supervision: J.W., W.X., C.W., and Z.Z. Y.T. and Z.Z. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.


* The members of the CURES are listed in the [Supplementary Appendix] (available in the online version).


Supplementary Material



Publication History

Received: 25 December 2024

Accepted: 21 June 2025

Accepted Manuscript online:
24 June 2025

Article published online:
17 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Barca-Hernando M, García-Ortega A, Martínez-Meñaca A, Ramírez-Martín MP, Rivas-Guerrero A, Tenes A. [Pulmonary embolism]. Open Respir Arch 2024; 6 (04) 100342
    PubMedSearch in Google Scholar
  • 2 Farmakis IT, Keller K, Barco S, Konstantinides SV, Hobohm L. From acute pulmonary embolism to post-pulmonary embolism sequelae. Vasa 2023; 52 (01) 29-37
    CrossrefPubMedSearch in Google Scholar
  • 3 Kuijer PM, Hutten BA, Prins MH, Büller HR. Prediction of the risk of bleeding during anticoagulant treatment for venous thromboembolism. Arch Intern Med 1999; 159 (05) 457-460
    CrossrefPubMedSearch in Google Scholar
  • 4 Keller K, Münzel T, Hobohm L, Ostad MA. Predictive value of the Kuijer score for bleeding and other adverse in-hospital events in patients with venous thromboembolism. Int J Cardiol 2021; 329: 179-184
    CrossrefPubMedSearch in Google Scholar
  • 5 Jara-Palomares L, Jiménez D, Bikdeli B. et al; RIETE investigators, RIETE Steering Committee Members: Members of the RIETE Group. Derivation and validation of a clinical prediction rule for thrombolysis-associated major bleeding in patients with acute pulmonary embolism: the BACS score. Eur Respir J 2020; 56 (06) 2002336
    CrossrefPubMedSearch in Google Scholar
  • 6 Chopard R, Piazza G, Falvo N. et al. An original risk score to predict early major bleeding in acute pulmonary embolism: the syncope, anemia, renal dysfunction (PE-SARD) bleeding score. Chest 2021; 160 (05) 1832-1843
    CrossrefPubMedSearch in Google Scholar
  • 7 Chopard R, Bertoletti L, Piazza G. et al. External validation of the PE-SARD risk score for predicting early bleeding in acute pulmonary embolism in the RIETE Registry. Thromb Res 2024; 235: 22-31
    CrossrefPubMedSearch in Google Scholar
  • 8 Villiger R, Méan M, Stalder O. et al. Prediction of very early major bleeding risk in acute pulmonary embolism: an independent external validation of the Pulmonary Embolism-Syncope, Anemia, and Renal Dysfunction (PE-SARD) bleeding score. J Thromb Haemost 2023; 21 (10) 2884-2893
    CrossrefPubMedSearch in Google Scholar
  • 9 Nopp S, Ay C. Bleeding risk assessment in patients with venous thromboembolism. Hamostaseologie 2021; 41 (04) 267-274
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Lecumberri R, Jiménez L, Ruiz-Artacho P. et al; RIETE investigators. Prediction of major bleeding in anticoagulated patients for venous thromboembolism: comparison of the RIETE and the VTE-BLEED scores. TH Open 2021; 5 (03) e319-e328
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138 (05) 1093-1100
    CrossrefPubMedSearch in Google Scholar
  • 12 Apostolakis S, Lane DA, Guo Y, Buller H, Lip GY. Performance of the HEMORR(2)HAGES, ATRIA, and HAS-BLED bleeding risk-prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS (evaluating the use of SR34006 compared to warfarin or acenocoumarol in patients with atrial fibrillation) study. J Am Coll Cardiol 2012; 60 (09) 861-867
    CrossrefPubMedSearch in Google Scholar
  • 13 Senoo K, Lip GY. Predictive abilities of the HAS-BLED and ORBIT bleeding risk scores in non-warfarin anticoagulated atrial fibrillation patients: an ancillary analysis from the AMADEUS trial. Int J Cardiol 2016; 221: 379-382
    CrossrefPubMedSearch in Google Scholar
  • 14 Gorog DA, Gue YX, Chao TF. et al. Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism: executive summary of a European and Asia-Pacific expert consensus paper. Thromb Haemost 2022; 122 (10) 1625-1652
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Lip GY, Lin HJ, Hsu HC. et al. Comparative assessment of the HAS-BLED score with other published bleeding risk scoring schemes, for intracranial haemorrhage risk in a non-atrial fibrillation population: the Chin-Shan community cohort tudy. Int J Cardiol 2013; 168 (03) 1832-1836
    CrossrefPubMedSearch in Google Scholar
  • 16 Brown JD, Goodin AJ, Lip GYH, Adams VR. Risk stratification for bleeding complications in patients with venous thromboembolism: application of the HAS-BLED bleeding score during the first 6 months of anticoagulant treatment. J Am Heart Assoc 2018; 7 (06) e007901
    CrossrefPubMedSearch in Google Scholar
  • 17 Aggarwal R, Ruff CT, Virdone S. et al. Development and validation of the DOAC score: a novel bleeding risk prediction tool for patients with atrial fibrillation on direct-acting oral anticoagulants. Circulation 2023; 148 (12) 936-946
    CrossrefPubMedSearch in Google Scholar
  • 18 Fang MC, Go AS, Chang Y. et al. A new risk scheme to predict warfarin-associated hemorrhage: the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol 2011; 58 (04) 395-401
    CrossrefPubMedSearch in Google Scholar
  • 19 Kim HK, Tantry US, Smith Jr SC. et al. The East Asian paradox: an updated position statement on the challenges to the current antithrombotic strategy in patients with cardiovascular disease. Thromb Haemost 2021; 121 (04) 422-432
    Thieme ConnectPubMedSearch in Google Scholar
  • 20 Vickers AJ, Cronin AM, Elkin EB, Gonen M. Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers. BMC Med Inform Decis Mak 2008; 8: 53
    CrossrefPubMedSearch in Google Scholar
  • 21 Ortiz Gómez S, Ruiz-Talero P, Muñoz O, Hoyos Pumarejo LM. Validation of the RIETE, Kuijer, and HAS-BLED models to assess 3-month bleeding risk in anticoagulated patients diagnosed with venous thromboembolic disease. Clin Appl Thromb Hemost 2024 ;30:10760296241271351
    PubMedSearch in Google Scholar
  • 22 Zhang Z, Lei J, Zhai Z. et al. Comparison of prediction value of four bleeding risk scores for pulmonary embolism with anticoagulation: a real-world study in Chinese patients. Clin Respir J 2019; 13 (03) 139-147
    CrossrefPubMedSearch in Google Scholar
  • 23 Lip GY, Lane DA. Assessing bleeding risk in atrial fibrillation with the HAS-BLED and ORBIT scores: clinical application requires focus on the reversible bleeding risk factors. Eur Heart J 2015; 36 (46) 3265-3267
    PubMedSearch in Google Scholar
  • 24 Raval AN, Cigarroa JE, Chung MK. et al; American Heart Association Clinical Pharmacology Subcommittee of the Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; and Council on Quality of Care and Outcomes Research. Management of patients on non-vitamin K antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association. Circulation 2017; 135 (10) e604-e633
    CrossrefPubMedSearch in Google Scholar
  • 25 Skowrońska M, Furdyna A, Ciurzyński M. et al. D-dimer levels enhance the discriminatory capacity of bleeding risk scores for predicting in-hospital bleeding events in acute pulmonary embolism. Eur J Intern Med 2019; 69: 8-13
    CrossrefPubMedSearch in Google Scholar
  • 26 Vizzotto LJH, Sepeda CDR, Miranda CH. Bleeding in patients hospitalized with acute pulmonary embolism in Brazil. Clinics (Sao Paulo) 2025; 80: 100573
    CrossrefPubMedSearch in Google Scholar
  • 27 Klok FA, Niemann C, Dellas C, Hasenfuß G, Konstantinides S, Lankeit M. Performance of five different bleeding-prediction scores in patients with acute pulmonary embolism. J Thromb Thrombolysis 2016; 41 (02) 312-320
    CrossrefPubMedSearch in Google Scholar
  • 28 Nishimoto Y, Yamashita Y, Morimoto T. et al; COMMAND VTE Registry-2 Investigators. External validation of the Pulmonary Embolism-Syncope, Anemia, and Renal Dysfunction bleeding score for early major bleeding in patients with acute pulmonary embolism: from the COMMAND VTE Registry-2. J Thromb Haemost 2024; 22 (10) 2784-2796
    CrossrefPubMedSearch in Google Scholar
  • 29 de Winter MA, Dorresteijn JAN, Ageno W. et al. Estimating bleeding risk in patients with cancer-associated thrombosis: evaluation of existing risk scores and development of a new risk score. Thromb Haemost 2022; 122 (05) 818-829
    Thieme ConnectPubMedSearch in Google Scholar
  • 30 Maestre A, Escribano JC, Lobo JL. et al; RIETE Investigators. Major bleeding in patients with pulmonary embolism presenting with syncope. Eur J Clin Invest 2022; 52 (07) e13774
    CrossrefPubMedSearch in Google Scholar
  • 31 Gaboreau Y, Zenatti N, Vermorel C, Imbert P, Bosson JL, Pernod G. Anemia and bleeding in patients receiving anticoagulant therapy for venous thromboembolism: comment. J Thromb Thrombolysis 2018; 46 (01) 84-87
    CrossrefPubMedSearch in Google Scholar
  • 32 den Exter PL, Woller SC, Robert-Ebadi H. et al. Management of bleeding risk in patients who receive anticoagulant therapy for venous thromboembolism: Communication from the ISTH SSC Subcommittee on Predictive and Diagnostic Variables in Thrombotic Disease. J Thromb Haemost 2022; 20 (08) 1910-1919
    CrossrefPubMedSearch in Google Scholar
  • 33 Yoshimoto T, Toyoda K, Ihara M. et al. Impact of previous stroke on clinical outcome in elderly patients with nonvalvular atrial fibrillation: ANAFIE Registry. Stroke 2022; 53 (08) 2549-2558
    CrossrefPubMedSearch in Google Scholar
  • 34 Garcia DA, Fisher DA, Mulder H. et al. Gastrointestinal bleeding in patients with atrial fibrillation treated with apixaban or warfarin: insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Am Heart J 2020; 221: 1-8
    CrossrefPubMedSearch in Google Scholar
  • 35 Yerramilli SK, Kokula P, Gupta SK. et al. Connective tissue abnormalities in patients with ruptured intracranial aneurysms and no known systemic connective tissue disorder. World Neurosurg 2020; 141: e829-e835
    CrossrefPubMedSearch in Google Scholar
  • 36 Severance S, Daylor V, Petrucci T, Gensemer C, Patel S, Norris RA. Hypermobile Ehlers-Danlos syndrome and spontaneous CSF leaks: the connective tissue conundrum. Front Neurol 2024; 15: 1452409
    CrossrefPubMedSearch in Google Scholar
  • 37 Crawford J, Herndon D, Gmitter K, Weiss J. The impact of myelosuppression on quality of life of patients treated with chemotherapy. Future Oncol 2024; 20 (21) 1515-1530
    CrossrefPubMedSearch in Google Scholar
  • 38 Falanga A, Marchetti M. Cancer-associated thrombosis: enhanced awareness and pathophysiologic complexity. J Thromb Haemost 2023; 21 (06) 1397-1408
    CrossrefPubMedSearch in Google Scholar
  • 39 Chu G, Valerio L, van der Wall SJ. et al. Tailoring anticoagulant treatment of patients with atrial fibrillation using a novel bleeding risk score. Heart 2020; 107: 549-555
    CrossrefPubMedSearch in Google Scholar
  • 40 Mihatov N, Secemsky EA, Kereiakes DJ. et al. Individualizing dual antiplatelet therapy (DAPT) duration based on bleeding risk, ischemic risk, or both: an analysis from the DAPT study. Cardiovasc Revasc Med 2022; 41: 105-112
    CrossrefPubMedSearch in Google Scholar
  • 41 Brinza C, Burlacu A, Tinica G, Covic A, Macovei L. A systematic review on bleeding risk scores' accuracy after percutaneous coronary interventions in acute and elective settings. Healthcare (Basel) 2021; 9 (02) 148
    CrossrefPubMedSearch in Google Scholar
  • 42 Becattini C, Agnelli G, Diamanti M. et al; COPE Investigators. Contemporary anticoagulant treatment strategies in patients with acute pulmonary embolism at different risk for death. Vascul Pharmacol 2023; 153: 107245
    CrossrefPubMedSearch in Google Scholar
  • 43 Lee A, Oley Jr F, Lo M. et al. Direct oral anticoagulants or low-molecular-weight heparins for venous thromboembolism in patients with brain tumors. Thromb Res 2021; 208: 148-155
    CrossrefPubMedSearch in Google Scholar
  • 44 Swartz AW, Drappatz J. Safety of direct oral anticoagulants in central nervous system malignancies. Oncologist 2021; 26 (05) 427-432
    CrossrefPubMedSearch in Google Scholar
  • 45 Camilli M, Lombardi M, Vescovo GM. et al. Efficacy and safety of novel oral anticoagulants versus low molecular weight heparin in cancer patients with venous thromboembolism: a systematic review and meta-analysis. Crit Rev Oncol Hematol 2020; 154: 103074
    CrossrefPubMedSearch in Google Scholar
  • 46 Kang W, Peng K, Yan VKC. et al. Direct oral anticoagulants versus low-molecular-weight heparin in patients with cancer-associated venous thrombosis: a cost-effectiveness analysis. J Pharm Policy Pract 2024; 17 (01) 2375269
    CrossrefPubMedSearch in Google Scholar
  • 47 Schaefer JK, Li M, Wu Z. et al. Anticoagulant medication adherence for cancer-associated thrombosis: a comparison of LMWH to DOACs. J Thromb Haemost 2021; 19 (01) 212-220
    CrossrefPubMedSearch in Google Scholar
  • 48 Kang DS, Yang PS, Kim D. et al. Racial differences in bleeding risk: an ecological epidemiological study comparing Korea and United Kingdom subjects. Thromb Haemost 2024; 124 (09) 842-851
    Thieme ConnectPubMedSearch in Google Scholar