Validation Of The Academic Research Consortium For High Bleeding ...

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Clinical research

DOI: 10.4244/EIJ-D-20-00052 Validation of the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria in patients undergoing percutaneous coronary intervention and comparison with contemporary bleeding risk scores Yasushi Ueki1, MD; Sarah Bär1, MD; Sylvain Losdat2, PhD; Tatsuhiko Otsuka1, MD; Christian Zanchin1, MD; Thomas Zanchin1, MD; Felice Gragnano1, MD; Giuseppe Gargiulo1, MD; George C.M. Siontis1, MD, PhD; Fabien Praz1, MD; Jonas Lanz1, MD; Lukas Hunziker1, MD; Stefan Stortecky1, MD; Thomas Pilgrim1, MD; Dik Heg2, PhD; Marco Valgimigli1, MD, PhD; Stephan Windecker1, MD; Lorenz Räber1, MD, PhD 1. Department of Cardiology, Bern University Hospital, Bern, Switzerland; 2. Institute of Social and Preventive Medicine and Clinical Trials Unit, University of Bern, Bern, Switzerland share print download PDF download media download citations reprint

Abstract

Aims: The Academic Research Consortium for High Bleeding Risk (ARC-HBR) defined consensus-based criteria for patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI). We aimed to validate the ARC-HBR criteria for the bleeding outcomes using a large cohort of patients undergoing PCI.

Methods and results: Between 2009 and 2016, patients undergoing PCI were prospectively included in the Bern PCI Registry. Patients were considered to be at HBR if at least one major criterion or two minor criteria were met. The primary endpoint was Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding at one year; ischaemic outcomes were assessed using the device-oriented composite endpoints (DOCE) of cardiac death, target vessel myocardial infarction, and target lesion revascularisation. Among 12,121 patients, those at HBR (n=4,781, 39.4%) had an increased risk of BARC 3 or 5 bleeding (6.4% vs 1.9%; p