BACKGROUND: The identification of bleeding risk factors in patients undergoing percutaneous coronary intervention (PCI) is essential to inform subsequent management. Whether clinical presentation per se affects bleeding risk after PCI remains unclear. AIMS: We aimed to assess whether clinical presentation per se predisposes to bleeding in patients undergoing PCI and if the Academic Research Consortium (ARC) High Bleeding Risk (HBR) criteria perform consistently in acute (ACS) and chronic (CCS) coronary syndrome patients. METHODS: Consecutive patients undergoing PCI from the Bern PCI Registry were stratified by clinical presentation. Bleeding events at one year were compared in ACS versus CCS patients, and the originally defined ARC-HBR criteria were assessed. RESULTS: Among 16,821 patients, 9,503 (56.5%) presented with ACS. At one year, BARC 3 or 5 bleeding occurred in 4.97% and 3.60% of patients with ACS and CCS, respectively. After adjustment, ACS remained associated with higher BARC 3 or 5 bleeding risk (adjusted HR 1.21, 95% CI: 1.01-1.43; p=0.034), owing to non-access site-related occurrences, which accrued mainly within the first 30 days after PCI. The ARC-HBR score had lower discrimination among ACS compared with CCS patients, and its performance slightly improved when ACS was computed as a minor criterion. CONCLUSIONS: ACS presentation per se predicts one-year major bleeding risk after PCI. The ARC-HBR score discrimination appeared lower in ACS than CCS, and its overall performance improved numerically when ACS was computed as an additional minor risk criterion.
BACKGROUND: The identification of bleeding risk factors in patients undergoing percutaneous coronary intervention (PCI) is essential to inform subsequent management. Whether clinical presentation per se affects bleeding risk after PCI remains unclear. AIMS: We aimed to assess whether clinical presentation per se predisposes to bleeding in patients undergoing PCI and if the Academic Research Consortium (ARC) High Bleeding Risk (HBR) criteria perform consistently in acute (ACS) and chronic (CCS) coronary syndrome patients. METHODS: Consecutive patients undergoing PCI from the Bern PCI Registry were stratified by clinical presentation. Bleeding events at one year were compared in ACS versus CCS patients, and the originally defined ARC-HBR criteria were assessed. RESULTS: Among 16,821 patients, 9,503 (56.5%) presented with ACS. At one year, BARC 3 or 5 bleeding occurred in 4.97% and 3.60% of patients with ACS and CCS, respectively. After adjustment, ACS remained associated with higher BARC 3 or 5 bleeding risk (adjusted HR 1.21, 95% CI: 1.01-1.43; p=0.034), owing to non-access site-related occurrences, which accrued mainly within the first 30 days after PCI. The ARC-HBR score had lower discrimination among ACS compared with CCS patients, and its performance slightly improved when ACS was computed as a minor criterion. CONCLUSIONS: ACS presentation per se predicts one-year major bleeding risk after PCI. The ARC-HBR score discrimination appeared lower in ACS than CCS, and its overall performance improved numerically when ACS was computed as an additional minor risk criterion.
Authors: Felice Gragnano; Marcel Zwahlen; Pascal Vranckx; Dik Heg; Kurt Schmidlin; Christian Hamm; Philippe Gabriel Steg; Giuseppe Gargiulo; Eugene P McFadden; Yoshinobu Onuma; Ply Chichareon; Edouard Benit; Helge Möllmann; Luc Janssens; Sergio Leonardi; Aleksander Zurakowski; Alessio Arrivi; Robert Jan Van Geuns; Kurt Huber; Ton Slagboom; Paolo Calabrò; Patrick W Serruys; Peter Jüni; Marco Valgimigli; Stephan Windecker Journal: J Am Heart Assoc Date: 2022-03-01 Impact factor: 6.106
Authors: Henri Kesti; Henna Mäkinen; Kalle Mattila; Samuli Jaakkola; Mikko Lintu; Pekka Porela Journal: J Clin Med Date: 2022-02-28 Impact factor: 4.241
Authors: Liang Dong; Cao Lu; Chen Wensen; Chen Fuzhong; Muhammad Khalid; Dong Xiaoyu; Li Guangjuan; Qian Yanxia; Zhang Yufeng; Liu Xinjian; Chen Leilei; Wang Junhong Journal: Front Cardiovasc Med Date: 2022-07-08
Authors: Amir Faour; Nicholas Collins; Trent Williams; Arshad Khan; Craig P Juergens; Sidney Lo; Darren L Walters; Derek P Chew; John K French Journal: PLoS One Date: 2021-10-26 Impact factor: 3.240