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Number of severe bleeding complications according to classification used: Is unified classification of bleeding

Magdalena Sionova, Peter Blasko, Stepan Jirous

  • 1Charles Univ.. motovska.zuzana@gmail.com.

Cardiology Journal
|July 24, 2015
PubMed

Insights

Different bleeding classifications significantly impact severe periprocedural bleeding rates after coronary angiography. The Bleeding Academic Research Consortium (BARC) classification showed the strongest association with hemodynamic compromise in patients undergoing these procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • Periprocedural bleeding is a critical complication of coronary angiography and percutaneous coronary intervention (PCI).
  • Standardized classification systems are crucial for reporting and comparing bleeding events.
  • Existing classifications may differ in their sensitivity to clinically significant bleeding outcomes.

Purpose of the Study:

  • To compare the incidence of severe periprocedural bleeding complications across different classification systems (TIMI, GUSTO, PLATO, BARC).
  • To evaluate the correlation between bleeding classifications and the actual hemodynamic status of patients.
  • To identify the most reliable classification for assessing bleeding severity in patients undergoing coronary procedures.

Main Methods:

  • Analysis of bleeding complications in 106 patients who underwent selective coronary angiography or PCI for ischemic heart disease.
  • Comparison of bleeding event rates using TIMI, GUSTO, PLATO, and BARC classifications.
  • Assessment of the association between severe bleeding and hemodynamic compromise using Kendall's tau-c correlation.

Main Results:

  • The rate of severe bleeding complications varied significantly, increasing up to fourfold depending on the classification used (TIMI 9.4% to BARC 35.9%).
  • A substantial proportion of bleeding events (54.7%) did not require specific treatment.
  • The Bleeding Academic Research Consortium (BARC) classification demonstrated the strongest negative correlation with hemodynamic compromise (Kendall's tau-c = -0.7552), indicating a robust association with clinical severity.

Conclusions:

  • The choice of bleeding classification significantly influences the reported percentage of severe periprocedural bleeding complications.
  • The BARC classification exhibits the strongest association with real hemodynamic status, suggesting its potential for widespread adoption.
  • Accurate classification of bleeding is essential for patient management and comparative effectiveness research in interventional cardiology.
Abstract

Keywords:
bleeding complicationsclassification of bleedingischemic heart disease

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