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Comparison of Performance between ARC-HBR Criteria and PRECISE-DAPT Score in Patients Undergoing Percutaneous
Sun Young Choi1,2, Moo-Hyun Kim1, Kwang-Min Lee1
1Department of Cardiology, Dong-A University Hospital, Busan 49201, Korea.
Insights
Predicting bleeding risk after percutaneous coronary intervention (PCI) is crucial. Both Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria and the PRECISE-DAPT score effectively predict bleeding events and death in Korean patients on dual antiplatelet therapy (DAPT).
Area of Science:
- Cardiology
- Clinical Research
- Medical Informatics
Background:
- Managing bleeding risk is critical for patients undergoing percutaneous coronary intervention (PCI).
- Standardized tools are needed to predict bleeding risk in this population.
- The Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria and PRECISE-DAPT score are proposed risk assessment tools.
Purpose of the Study:
- To compare the predictive performance of ARC-HBR criteria and the PRECISE-DAPT score for bleeding events in Korean patients undergoing PCI.
- To evaluate the ability of these scores to predict all-cause death in the same cohort.
- To assess the utility of these scores in patients receiving dual antiplatelet therapy (DAPT).
Main Methods:
- A retrospective analysis of 1418 consecutive patients undergoing PCI between January 2012 and December 2018.
- Calculation and comparison of the predictive accuracy (Area Under the Curve - AUC) of ARC-HBR criteria and PRECISE-DAPT score for various bleeding definitions (BARC, TIMI, GUSTO) and all-cause death.
- Statistical comparison of the discriminant ability between the two scoring systems.
Main Results:
- Both ARC-HBR criteria and PRECISE-DAPT score demonstrated high predictive performance for bleeding events across different definitions (AUCs ranging from 0.68 to 0.82).
- Both scores also showed high predictive accuracy for all-cause death (AUC 0.82).
- The predictive ability of the PRECISE-DAPT score was not significantly different from the ARC-HBR criteria for both bleeding events and all-cause death.
Conclusions:
- The ARC-HBR criteria and PRECISE-DAPT score are effective tools for predicting 1-year bleeding events in Korean patients treated with DAPT after PCI.
- The simpler PRECISE-DAPT score offers comparable utility to the ARC-HBR criteria in predicting bleeding and all-cause death post-PCI.
- These findings support the use of either score for risk stratification in this patient population.
Abstract:
The proper management of bleeding risk in patients undergoing percutaneous coronary intervention (PCI) is critical. Recently, the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria have been proposed as a standardized tool for predicting bleeding risk. We sought to compare the predictive performance of ARC-HBR criteria and the PRECISE-DAPT score for bleeding in Korean patients undergoing PCI. We recruited 1418 consecutive patients undergoing PCI from January 2012 through December 2018 (Dong-A University Medical Center, Busan, Korea). The ARC-HBR and PRECISE-DAPT scores showed a high AUC for three bleeding definitions (AUC 0.75 and 0.77 for BARC 3 to 5; AUC 0.68 and 0.71 for TIMI minor to major; AUC 0.81 and 0.82 for GUSTO moderate to severe, respectively) and all-cause death (AUC 0.82 and 0.82, respectively). When compared with the ARC-HBR score, the discriminant ability of the PRECISE-DAPT score was not significantly different for bleeding events and all-cause death. The ARC-HBR criteria and PRECISE-DAPT scores demonstrated reasonably good discriminatory capacity with respect to 1-year bleeding events in Korean patients treated with DAPT, regardless of the bleeding definition. Our findings also suggest that the simple PRECISE-DAPT score is as useful as ARC-HBR criteria in predicting bleeding and all-cause death after PCI.
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