Shreya Agrawal: Integrated Risk Scores for Thrombosis and Bleeding
Shreya Agrawal, Consultant Hematologist and Bone marrow transplant physician at S. L. Raheja Hospital – A Fortis Associate, shared a post on LinkedIn:
“In hematology and cardiology practice, risk stratification is everything.
We often talk about thrombosis and bleeding as separate problems — but in reality, they coexist in a delicate balance.
The real art lies in identifying who needs prolonged anticoagulation, who needs dual antiplatelet therapy, and who is at high bleeding risk.
There are several validated tools that help us move from instinct-based decisions to evidence-based precision:
- VTE recurrence after anticoagulation – Vienna, HERDOO2
- Bleeding risk on OAC – VTE-BLEED, CHAP
- Post-PCI risk stratification – DAPT score, PRECISE-DAPT
- PAD and cardiovascular risk – OAC3-PAD, SMART
- Diabetes and 10-year CV risk – SCORE2
Each tool incorporates clinical variables we routinely assess — age, renal function, hemoglobin, prior bleeding, inflammatory markers, comorbidities — but converts them into structured decision support.
Why this matters:
- Avoid unnecessary prolonged anticoagulation
- Identify patients who truly benefit from extended therapy
- Reduce preventable bleeding
- Personalize cardiovascular prevention
As we move toward precision medicine, structured risk calculators are no longer optional — they’re essential.
Curious to know — how many of these scores are you actively using in daily practice?”
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