Predictive Value of HAS-BLED and HEMORR2HAGES Bleeding Risk Scores After Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Clinical Risk Assessment
• Interventional Cardiology

Background:

• Existing bleeding risk scores like HAS-BLED and HEMORR2HAGES are widely used but have limited validation in patients undergoing percutaneous coronary intervention (PCI).
• Accurate bleeding risk assessment is crucial for managing patients post-PCI, especially those on antithrombotic therapy.

Purpose of the Study:

• To evaluate and compare the predictive performance of HAS-BLED, HEMORR2HAGES, and PARIS bleeding risk scores in patients undergoing PCI.
• To assess the association between bleeding risk scores and major bleeding events or patient-oriented composite endpoints over a 2-year follow-up.

Main Methods:

• A prospective study of 1,080 consecutive patients undergoing PCI between 2015 and 2017.
• Bleeding risk scores (HAS-BLED, HEMORR2HAGES, PARIS) were calculated at baseline.
• Patients were followed for 2 years to record major bleeding events (BARC types 3-5) and patient-oriented composite endpoints.

Main Results:

• All evaluated bleeding risk scores demonstrated statistically significant predictive ability for bleeding events.
• The HEMORR2HAGES score showed superior performance (C-statistic=0.73) compared to HAS-BLED (C-statistic=0.66) and PARIS (C-statistic=0.66) for predicting major bleeding.
• Patients categorized as high-risk for bleeding experienced a greater incidence of patient-oriented composite endpoints.

Conclusions:

• HEMORR2HAGES, HAS-BLED, and PARIS scores are effective in predicting bleeding events after PCI.
• Elevated bleeding risk in PCI patients is associated with increased ischemic risk and higher 2-year mortality.