The main advantage of the more -VASc scheme for primary stroke pre- vention is improved stratification of individuals estimated to be at low to moderate risk using CHADS2 (scores of 0 to 1). A study of 45576 such patients found combined stroke and thromboembolism rates per 100 person-years ranging from -VASc of 0 to 1.79, respectively, resulting in significantly improved prediction.383 Instruments have also been proposed for stratifying risk of bleeding associated with warfarin treatment for AF. In the HAS-BLED scheme (Table 3), 1 point is assigned each for hypertension, abnormal renal or liver function, past stroke, past bleeding history or predisposition, labile INR (ie, poor time in therapeutic range), older age (age >65 years), and use of certain drugs (concomitant antiplatelet or nonsteroidal anti- inflammatory agent use, alcohol abuse).381 In a validation anal- ysis of data from 2293 subjects randomized to idraparinux or vitamin K antagonist therapy, the HAS-BLED score was mod- erately predictive (HAS-BLED >2: HR, 1.9 for clinically rele- vant bleeding; HR, 2.4 for major bleeding).382 The ATRIA Risk derived its point scheme from the Anticoagulation and Risk Factors in Atrial Fibrillation study, assigning 3 points for anemia or severe renal disease (estimated glomerular filtra- tion rate <30 mL/min or dialysis dependent), 2 for age 75 years, and 1 for any prior hemorrhage diagnosis or hyperten- sion. Subjects in a validation cohort were successfully divided into groups at low (ATRIA score of 0 to 3, <1%/y) and high (ATRIA score of 5 to 10, >5%/y) risk for major hemorrhage. Table 3. 