DOACScore

The DOAC score helps categorise the one year bleeding risk of patients on DOAC's and those who might benefit from left atrial appendage closure and/or catheter ablation.

This application is provided for the use of cardiologists and cardiac electrophysiologists, not the general public. If the user is not a cardiologist and wishes to use the app, then they should consult their cardiologist for further advice. The app does not provide any information regarding the dose or usage of direct acting anticoagulants.

The DOAC score represents a significant scientific advance in anticoagulation management that balances the benefit of preventing stroke and systemic embolization with the risk of bleeding in patients with atrial fibrillation.The DOAC score allows the clinician to accurately quantify bleeding risk in patients taking DOACs while also helping identify bleeding risk factors and to correct those that are modifiable such as better controlling blood pressure, removing concomitant unnecessary antiplatelet or NSAID use, and counseling the patient about such factors. The bleeding risk assessment with the DOAC score and its clinical adoption improves patient care, highlight patients in whom risks are reversible, and provides caution when needed.

The DOAC score could also potentially serve as a quantifiable measure with respect to selecting patients who might benefit from left atrial appendage closure and/or catheter ablation.

The % one year bleeding risk is taken from development and validaiton cohorts and should only be considered a rough estimate.

1. Aggarwal R, Ruff CT, Virdone S, Perreault S, Kakkar AK, Palazzolo MG, 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 [Internet]. 2023 Sep 19 [cited 2025 Jan 14];148(12):936–46. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064556

2. Ezekowitz MD, Kamareddine M. Filling an Important Knowledge Gap: The DOAC Score. Circulation [Internet]. 2023 Sep 19 [cited 2025 Jan 15];148(12):947–9. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066316

3. Harano Y, Yamamoto M, Shimura T, Okubo M, Koyama Y, Yamaguchi R, et al. Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study. JAHA [Internet]. 2024 Nov 7 [cited 2024 Nov 15];e036417. Available from: https://www.ahajournals.org/doi/10.1161/JAHA.124.036417