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Simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) Definition Predicts Bleeding Events in
Yu Sato1, Akiomi Yoshihisa1,2, Ryohei Takeishi1
1Department of Cardiovascular Medicine, Fukushima Medical University.
Insights
The simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) definition effectively identifies patients with heart failure (HF) at high risk for bleeding events after hospital discharge.
Area of Science:
- Cardiology
- Clinical Research
- Patient Risk Stratification
Background:
- The simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) definition was previously validated for patients with coronary artery disease (CAD).
- Its applicability to patients with heart failure (HF) for identifying high bleeding risk (HBR) was not established.
Purpose of the Study:
- To evaluate the utility of the simplified ARC-HBR definition in identifying high bleeding risk (HBR) in patients hospitalized for heart failure (HF).
Main Methods:
- A cohort of 2,437 patients hospitalized for HF was analyzed.
- Patients were classified as HBR or non-HBR using the simplified ARC-HBR definition.
- Post-discharge bleeding events (hemorrhagic stroke, gastrointestinal bleeding) were tracked.
Main Results:
- 83.1% of HF patients met the simplified ARC-HBR criteria for high bleeding risk.
- The HBR group was significantly older and had a lower prevalence of CAD.
- Post-discharge bleeding events were significantly more frequent in the HBR group (log-rank P<0.001).
- The simplified ARC-HBR definition accurately predicted bleeding events (HR 2.777, P=0.001).
Conclusions:
- The simplified ARC-HBR definition is a valuable tool for predicting bleeding risk in heart failure patients.
- This definition can aid in identifying HF patients who may benefit from closer monitoring or tailored management strategies to prevent bleeding.
Background:
It has recently been reported that the simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) definition, which excludes 6 rare criteria, is comparable to the original ARC-HBR definition in predicting major bleeding in patients with coronary artery disease (CAD) who undergo percutaneous coronary intervention. In this study, we investigated whether the simplified ARC-HBR definition could be applied to patients with heart failure (HF) to identify those at high bleeding risk (HBR).
Methods And Results:
In all, 2,437 patients hospitalized for HF were enrolled in this study. Patients were divided into 2 groups based on the simplified ARC-HBR definition: those at HBR (n=2,026; 83.1%) and those not (non-HBR group; n=411; 16.9%). The HBR group was older (72.0 vs. 61.0 years; P<0.001) and had a lower prevalence of CAD (31.1% vs. 36.5%; P=0.034) than the non-HBR group. Kaplan-Meier analysis showed that post-discharge bleeding events defined as hemorrhagic stroke or gastrointestinal bleeding were more frequent in the HBR than non-HBR group (log-rank P<0.001). The simplified ARC-HBR definition accurately predicted bleeding events (Fine-Gray model; hazard ratio 2.777, 95% confidence interval 1.464-5.270, P=0.001).
Conclusions:
The simplified ARC-HBR definition predicts a high risk of bleeding events in patients with HF.
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