A Systematic Review on Bleeding Risk Scores' Accuracy after Percutaneous Coronary Interventions in Acute and Elective...

Area of Science:

• Cardiology
• Clinical Pharmacology
• Medical Informatics

Background:

• Dual antiplatelet therapy (DAT) is standard after percutaneous coronary intervention (PCI) but increases bleeding risk.
• Predictive models are needed to stratify bleeding risk in patients on DAT.
• This review focuses on bleeding risk scores in the context of modern PCI and antiplatelet agents.

Purpose of the Study:

• To systematically review and assess the performance of existing and emerging bleeding risk scores.
• To evaluate the predictive accuracy of these scores for hemorrhagic events in patients undergoing PCI.
• To understand the utility of these scores in the current clinical landscape.

Main Methods:

• Systematic literature search of PubMed, ScienceDirect, and Cochrane databases.
• Inclusion of studies developing or validating bleeding risk scores in adult PCI patients on DAT.
• Risk of bias assessment using the Prediction Model Risk Of Bias Assessment Tool (PROBAST).

Main Results:

• Eighteen studies were included in the systematic review.
• Bleeding risk scores demonstrated modest to good discriminatory power (C-statistics 0.49-0.82).
• In-hospital bleeding prediction models showed good performance (C-statistics 0.70-0.80).

Conclusions:

• Current bleeding risk scores provide valuable, albeit variable, predictive performance for hemorrhagic events.
• Utilizing these scores in clinical practice can improve the identification of patients at high risk of bleeding.
• Further research may refine these scores for optimal risk stratification in contemporary PCI patients.