Performance of the Academic Research Consortium High Bleeding Risk Criteria in Patients With ST-Segment Elevation
Duygu Inan1, Ahmet C Yumurtas2, Barıs Simsek2
1Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey.
Insights
The Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria effectively predict in-hospital bleeding and adverse outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). These criteria identify patients at higher risk for complications and mortality.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Risk Stratification
Background:
- ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) are at risk for bleeding and adverse outcomes.
- Accurate prediction of these events is crucial for patient management.
Purpose of the Study:
- To evaluate the predictive ability of the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria for in-hospital bleeding and adverse outcomes.
- To assess the association of ARC-HBR criteria with mortality and hospital duration in STEMI patients undergoing pPCI.
Main Methods:
- A cohort of 1441 STEMI patients undergoing pPCI was analyzed.
- Patients were categorized into High Bleeding Risk (HBR) and non-HBR groups.
- Logistic regression analysis was used to identify independent predictors of in-hospital bleeding and adverse outcomes.
Main Results:
- 9% of patients experienced bleeding complications.
- Hypertension and ARC-HBR independently predicted in-hospital bleeding.
- Patients in the HBR group had significantly longer hospital duration and higher mortality rates.
Conclusions:
- The ARC-HBR criteria are valuable tools for predicting in-hospital bleeding complications in STEMI patients undergoing pPCI.
- Utilizing ARC-HBR criteria can aid in identifying high-risk patients who may benefit from closer monitoring and tailored management strategies.
Abstract:
We assessed the ability of predicting mortality and total in-hospital bleeding and adverse outcomes by the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). A total of 1441 STEMI patients were recruited: HBR group 354 (25%) patients and non-HBR group of 1087 (75%) patients. A total of 131 patients (9%) had a bleeding complication during hospitalization. The bleeding complications were also categorized according to other conventional bleeding scores. According to these conventional scores, all bleeding categories were associated with HBR. In univariate logistic regression analysis, female gender, diabetes mellitus, hypertension (HT) and HBR were associated with in-hospital bleeding. However, in multivariable analysis only HT (Odds Ratio [OR] 1.528, 95% CI 1.020-2.290; P = .040) and HBR (OR 1.612, 95% CI 1.075-2.428; P = .022) independently predicted total in-hospital bleeding complications. Hospital duration was longer and mortality rate was significantly higher in patients with HBR (OR 8.755, 95% CI 5.864-13.074; P < .01). The ARC-HBR criteria may predict in-hospital bleeding events and adverse outcomes in STEMI patients undergoing pPCI.
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