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pandora necklaces The HAS BLED score accounts for (age>65 years, hypertension, abnormal renal and liver function, prior stroke, bleeding history (or predisposition), drugs predisposing to bleed, alcohol use disorders, and labile international normalized ratio.While these risk scores provide baseline estimates of risk to guide whether to treat with an oral anticoagulant, they do not provide insight into optimal treatment selection when treatment is clearly indicated. The efficacy of oral anticoagulants in preventing thromboembolism in patients with atrial fibrillation is well known, with many studies reporting over 60%5 6 7 8 reduction in stroke for patients with non valvular atrial fibrillation. Also known is the potential for anticoagulants to increase the risk of major bleeding.6 7 8The updated 2012 European Society of Cardiology guidelines8 and the National Institute for Health and Care Excellence guidelines9 recommend that patients with at least one risk factor included in the CHA2DS2 VASc score be considered for anticoagulation therapy (excluding female patients under age 65 years with lone atrial fibrillation), and that anticoagulation should be offered to patients with atrial fibrillation and a CHA2DS2 VASc score of 2 or more.8 9 However, which anticoagulant to offer remains debated.8 9 10 When a clinician and patient decide to initiate anticoagulation therapy, accurate predictions of benefit (prevention of thromboembolism) or harm (increased risk of major bleeding) with different oral anticoagulation agents can help guide treatment choice.The Randomized Evaluation of Long Term Anticoagulation Therapy (RE LY) trial compared the effectiveness of dabigatran, a novel oral anticoagulation agent, to warfarin pandora necklaces.

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