Antithrombotic Therapy and Invasive Procedures

To the Editor: Baron et al. (May 30 issue) 1 make important suggestions in their review article; however, we propose that quantitative assessment of iatrogenic bleeding hazards must be considered as well as thrombosis prevention. 1 Although CHA 2 DS 2 –VASc scoring for atrial fibrillation is mentioned, the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly (HAS-BLED) score for bleeding has also been validated. 2 Both scores calculate estimated annual risks and benefits and hence can guide future therapy. Among the diverse causes of major bleeding outcomes associated with antithrombotic agents are periprocedural, intracranial, and gastrointestinal . . .