Validation of Japanese Bleeding Risk Criteria in Patients After Percutaneous Coronary Intervention and Comparison
Takeshi Shimizu1, Yuya Sakuma1, Yuta Kurosawa1
1Department of Cardiovascular Medicine, Fukushima Medical University Fukushima Japan.
Insights
The Japanese high bleeding risk (J-HBR) criteria effectively identify patients undergoing percutaneous coronary intervention at high risk for bleeding events. Bleeding risk increases with the J-HBR score, comparable to other established risk scores.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Risk Stratification
Background:
- Assessing bleeding risk in patients undergoing percutaneous coronary intervention (PCI) is crucial.
- The utility of the Japanese high bleeding risk (J-HBR) criteria compared to other risk scores needs further investigation.
Purpose of the Study:
- To evaluate the effectiveness of the J-HBR criteria in identifying patients at high bleeding risk after PCI.
- To compare the J-HBR criteria with contemporary bleeding risk assessment tools.
Main Methods:
- Retrospective analysis of 1,643 patients who underwent PCI between 2010 and 2019.
- Calculation of J-HBR scores and comparison of bleeding event rates between patients meeting and not meeting J-HBR criteria.
- Assessment of sensitivity, specificity, and discriminative ability (C-statistic) of J-HBR compared to other risk scores.
Main Results:
- 69.6% of patients met the J-HBR criteria, with significantly higher 1-year major bleeding rates (4.8% vs. 0.6%, P<0.001).
- J-HBR criteria demonstrated high sensitivity (94.8%) but low specificity (31.4%) for predicting major bleeding.
- The J-HBR score's discriminative ability (C-statistic=0.75) was comparable to other risk scores, with bleeding risk increasing alongside the score.
Conclusions:
- The J-HBR criteria are effective in identifying high bleeding risk patients post-PCI with high sensitivity.
- Bleeding risk is closely associated with the J-HBR score and its components, including chronic kidney disease, heart failure, and active malignancy.
- The J-HBR score offers comparable discriminative ability to existing bleeding risk scores.
Abstract:
The utility of the Japanese version of high bleeding risk (J-HBR) criteria compared with contemporary bleeding risk criteria, including Academic Research Consortium for High Bleeding Risk criteria, has not been fully investigated. This study included patients who underwent percutaneous coronary intervention between 2010 and 2019. The J-HBR score was calculated by assigning 1 point for each major criterion and 0.5 points for each minor criterion in the J-HBR criteria. Among 1,643 patients, 1,143 (69.6%) met the J-HBR criteria. Accumulated major bleeding event rates at 1 year were higher among those who met the J-HBR criteria (4.8% vs. 0.6%; P<0.001). J-HBR criteria had higher sensitivity (94.8%) and lower specificity (31.4%) than contemporary bleeding risk criteria in predicting major bleeding. Bleeding events increased with increasing J-HBR score. The C statistic for the J-HBR score for predicting major bleeding at 1 year was 0.75 (95% confidence interval 0.69-0.81), and is comparable to that of other risk scores. In multivariate analysis, of the factors included in J-HBR criteria, chronic kidney disease, heart failure, and active malignancy were associated with major bleeding. J-HBR criteria identified patients at high bleeding risk with high sensitivity and low specificity. Bleeding risk was closely related to J-HBR score and its individual components. The discriminative ability of the J-HBR score was comparable to that of contemporary bleeding risk scores.
More Related Videos
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:28Cardiac Catheterization I: Pre-Procedure Overview