Takeda et al reported the BIWACO score for predicting net adverse clinical events (NACE) in a patient with atrial fibrillation following percutaneous coronary intervention (PCI). The authors are from Koto Memoiral Hospital, Kohka Public Hospital, Nagahama Red Cross Hospital, Shiga Hospital JCHO, and Omi Medical Center in Japan.
BIWACO is an acronym based on the 5 parameters of the score. It is also derived from Bleeding and thrombotic risk evaluation In patients With Atrial fibrillation under COronary intervention.
Patient selection: on anticoagulation for atrial fibrillation following percutaneous coronary intervention (PCI)
Outcome: net adverse clinical events (NACE), primarily bleeding and thrombotic events or death
Parameters:
(1) brain infarction history (B)
(2) impaired renal function (I)
(3) warfarin (WA)
(4) congestive heart failure (C)
(5) older age (O)
Parameter
Finding
Points
history of brain infarction
no
0
yes
1
impaired renal function
no
0
yes
1
warfarin therapy
no
0
yes
1
congestive heart failure
no
0
yes
1
age
< 78 years
0
>= 78 years
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
Score
Percent NACE
0
3.2%
1
10.5%
2
15%
3
45%
4
78%
5
> 78%
Performance:
• The area under the ROC curve was 0.77.
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