Prior ischemic strokes are non-inferior for predicting future ischemic strokes than CHA2DS2-VASc score in hemodialysis patients with non-valvular atrial fibrillation

Table 3 Comparing the AUC of the CHA₂DS₂-VASc and HAS-BLED scores with their components in predicting ischemic stroke risk or major bleeding respectively, in the study population

Variable	All patients (n = 268)			Without warfarin (n = 180)
Variable	AUC	95% CI	P value	AUC	95% CI	P value
CHA₂DS₂-VASc components
CHF (yes)	0.49	0.40–0.58	0.84	0.46	0.35–0.58	0.52
Hypertension (Yes)	0.50	0.41–0.60	0.95	0.49	0.38–0.60	0.84
Age ≥ 75 years (yes)	0.49	0.40–0.58	0.78	0.47	0.36–0.58	0.62
DM (yes)	0.54	0.45–0.63	0.36	0.52	0.41–0.64	0.68
Prior stroke or TIA (yes)	0.67	0.58–0.76	< 0.001	0.67	0.56–0.78	0.003
Vascular disease (yes)	0.50	0.40–0.59	0.92	0.49	0.38–0.61	0.91
Age 65–74 years (yes)	0.52	0.43–0.61	0.66	0.51	0.40–0.63	0.81
Sex (female)	0.52	0.42–0.61	0.71	0.48	0.37–0.59	0.73
*CHA₂DS₂-VASc score*	0.63	0.54–0.72	0.006	0.59	0.48–0.70	0.11
HAS-BLED components
Hypertension (yes)	0.46	0.33–0.59	0.50	0.45	0.29–0.61	0.54
Abnormal renal function (yes)	0.50	0.35–0.65	1.00	0.50	0.35–0.65	1.00
Abnormal liver function (yes)	0.51	0.38–0.63	0.92	0.51	0.36–0.67	0.85
Prior stroke (yes)	0.44	0.32–0.55	0.31	0.43	0.29–0.57	0.37
Prior major bleeding (yes)	0.59	0.47–0.72	0.15	0.60	0.45–0.76	0.19
Labile INR (yes)	0.49	0.38–0.62	0.95	0.50	0.34–0.65	0.96
Age > 65 years (yes)	0.40	0.27–0.52	0.09	0.47	0.31–0.63	0.71
Prior alcohol or drug usage (yes)	0.53	0.40–0.65	0.68	0.52	0.36–0.68	0.81
Medication usage predisposing to bleeding (yes)	0.46	0.31–0.52	0.55	0.54	0.39–0.69	0.58
*HAS-BLED score*	0.47	0.35–0.57	0.62	0.49	0.34–0.65	0.94

CHA₂DS₂-VASc≥6 had a sensitivity of 61% and a specificity of 65% for predicting ischemic stroke, with +LR 1.75 and –LR 0.60
Prior stroke or TIA had a sensitivity of 61% and a specificity of 73% for predicting ischemic stroke, with +LR 2.25 and –LR 0.53
HAS-BLED≥4 had a sensitivity of 54% and a specificity of 50% for predicting major bleeding, with +LR 1.09 and –LR 0.91
Prior major bleeding had a sensitivity of 42% and a specificity of 76% for predicting major bleeding, with +LR 1.76 and –LR 0.76
Abbreviations: CHF congestive heart failure, DM diabetes mellitus, TIA transient ischemic attack

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