Related Experiment Video
Updated: May 6, 2026
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Prognostic implications of bleeding measured by Bleeding Academic Research Consortium (BARC) categorisation in
Dragan M Matic1, Dejan G Milasinovic, Milika R Asanin
1Emergency Department, Clinic for Cardiology, Clinical Center of Serbia, , Belgrade, Serbia.
Insights
Bleeding Academic Research Consortium (BARC) type 3b bleeding significantly increases 1-year mortality risk in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). This study highlights bleeding severity as a critical predictor of death post-PCI.
Area of Science:
- Cardiology
- Clinical Research
- Patient Outcomes
Background:
- In-hospital bleeding is a known complication following percutaneous coronary intervention (PCI).
- The Bleeding Academic Research Consortium (BARC) classification provides standardized criteria for defining bleeding events.
- Understanding the prognostic implications of BARC-defined bleeding in ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI is crucial.
Purpose of the Study:
- To examine the association between in-hospital bleeding, categorized by BARC classification, and both short-term and long-term mortality.
- To assess the predictive value of different BARC bleeding types for mortality in unselected patients undergoing primary PCI for STEMI.
Main Methods:
- Analysis of a prospective registry of consecutive STEMI patients undergoing primary PCI at a high-volume center.
- Reconstruction of BARC-defined bleeding events from detailed, prospectively collected clinical data.
- Primary outcome assessed was mortality at 1 year post-procedure.
Main Results:
- Of 1808 STEMI patients, 6.4% experienced BARC type ≥2 bleeding.
- A clear gradient of increasing 1-year mortality was observed with worsening BARC bleeding severity.
- BARC type 3a and 3b bleeding were identified as independent predictors of 1-year mortality (HR 1.99 and 3.22, respectively).
Conclusions:
- Bleeding events, as defined by the BARC classification, show a hierarchical correlation with 1-year mortality after primary PCI for STEMI.
- BARC type 3b bleeding represents the strongest independent predictor of 1-year mortality in this patient cohort.
Objective:
To investigate the relationship between inhospital bleeding as defined by Bleeding Academic Research Consortium (BARC) consensus classification and short-term and long-term mortality in unselected patients admitted for primary percutaneous coronary intervention (PCI).
Methods:
We analysed data of all consecutive patients with ST segment elevation myocardial infarction (STEMI) admitted for primary PCI, enrolled in a prospective registry of a high volume centre. The BARC-defined bleeding events were reconstructed from the detailed, prospectively collected clinical data. The primary outcome was mortality at 1 year.
Results:
Of the 1808 patients with STEMI admitted for primary PCI, 115 (6.4%) experienced a BARC type ≥2 bleeding. As the BARC bleeding severity worsened, there was a gradient of increasing rates of 1-year death. The 1-year mortality rate increased from 11.5% with BARC 0+1 type to 43.5% with BARC type 3b bleeding. After multivariable adjustment for demographic and clinical characteristics of patients, the independent predictors of 1-year death were BARC type 3a (HR 1.99; 95% CI 1.16 to 3.40, p=0.012) and BARC type 3b bleeding (HR 3.22; 95% CI 1.67 to 6.20, p<0.0001).
Conclusions:
The present study demonstrated that bleeding events defined according to the BARC classification hierarchically correlate with 1-year mortality after admission for primary PCI. The strongest predictor of 1-year mortality is the BARC type 3b bleeding.
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:14SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...