Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary...

Area of Science:

• Cardiology
• Interventional Cardiology
• Clinical Risk Prediction

Background:

• Patients with acute myocardial infarction (AMI) managed with percutaneous coronary intervention (PCI) via radial artery access are at risk of bleeding.
• Accurate estimation of bleeding risk is crucial for optimizing patient management and outcomes.

Purpose of the Study:

• To evaluate the accuracy of various bleeding risk scores in predicting 30-day bleeding events in patients with AMI undergoing transradial PCI.
• To compare the predictive performance of different scoring systems, including ACUITY-HORIZONS, ACTION, CRUSADE, and HAS-BLED.

Main Methods:

• Retrospective analysis of 1,651 patients diagnosed with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI).
• Assessment of predictive validity of bleeding risk scores using receiver operating characteristic (ROC) curves for 30-day bleeding events.
• Identification of predictors for 30-day bleeding and mortality.

Main Results:

• ACUITY-HORIZONS demonstrated the highest area under the curve (AUC) for predicting 30-day bleeding, followed by ACTION and CRUSADE; HAS-BLED had the lowest AUC.
• A cut-off score of 17 for ACUITY-HORIZONS showed the best discrimination for Thrombolysis in Myocardial Infarction (TIMI) 30-day serious bleeding.
• ACUITY-HORIZONS score > 17, low systolic blood pressure, and Killip class III/IV predicted 30-day bleeding risk. Myocardial infarction and TIMI major bleeding predicted 30-day mortality.

Conclusions:

• The ACUITY-HORIZONS score is the most reliable system for predicting 30-day bleeding in AMI patients undergoing transradial PCI.
• In the transradial context, bleeding and myocardial infarction within 30 days are significantly associated with 30-day mortality.