The predictive value of the ARC-HBR criteria for in-hospital bleeding risk following percutaneous coronary intervention in patients with acute coronary syndrome

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS IJC Heart and Vasculature Pub Date : 2024-10-19 DOI:10.1016/j.ijcha.2024.101527
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Abstract

Background

The Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria were proposed for predicting bleeding risk in patients undergoing percutaneous coronary intervention (PCI). However, there is a lack of research evaluating the risk of in-hospital bleeding following PCI for acute coronary syndrome (ACS) utilizing the ARC-HBR criteria.

Methods and results

This study involved 1013 ACS patients who underwent PCI and dual antiplatelet therapy. There were 63 cases of in-hospital bleeding events (6.22 %). According to the ARC-HBR criteria, patients classified as HBR had a significantly greater bleeding rate than non-HBR patients (15.81 % vs. 1.99 %, p < 0.001). As the CRUSADE score category increased, the risk of bleeding also increased. The area under the receiver operating characteristic curve (AUC) of the ARC-HBR criteria was significantly greater than that of the CRUSADE score for bleeding (0.751 vs. 0.696, p < 0.0001). Subgroup analysis revealed that the ARC-HBR criteria exhibited better predictive ability for ST-segment elevation myocardial infarction (STEMI, AUC 0.767 vs. 0.694, p = 0.020) but comparable predictive ability in patients with unstable angina (AUC 0.756 vs. 0.644, p = 0.213), non-ST-segment elevation myocardial infarction (AUC 0.713 vs. 0.683, p = 0.644), and non-ST-segment elevation ACS (AUC 0.739 vs. 0.687, p = 0.330).

Conclusion

Compared with the CRUSADE score, the ARC-HBR criteria demonstrate superior predictive ability for in-hospital bleeding events during PCI in ACS patients. Routine assessment of the ARC-HBR score might be helpful for identifying high-risk individuals in this specific population.
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ARC-HBR 标准对急性冠状动脉综合征患者经皮冠状动脉介入治疗后院内出血风险的预测价值
背景高出血风险学术研究联盟(ARC-HBR)标准被提出用于预测经皮冠状动脉介入治疗(PCI)患者的出血风险。然而,目前还缺乏利用 ARC-HBR 标准评估急性冠状动脉综合征(ACS)PCI 术后院内出血风险的研究。方法和结果本研究涉及 1013 例接受 PCI 和双联抗血小板治疗的 ACS 患者。共发生 63 例院内出血事件(6.22%)。根据 ARC-HBR 标准,HBR 患者的出血率明显高于非 HBR 患者(15.81 % vs. 1.99 %,p < 0.001)。随着 CRUSADE 评分类别的增加,出血风险也随之增加。在出血方面,ARC-HBR 标准的接收器操作特征曲线下面积(AUC)明显大于 CRUSADE 评分(0.751 vs. 0.696,p < 0.0001)。亚组分析显示,ARC-HBR 标准对 ST 段抬高型心肌梗死(STEMI,AUC 0.767 vs. 0.694,p = 0.020)具有更好的预测能力,但对不稳定型心绞痛(AUC 0.756 vs. 0.644,p = 0.结论与 CRUSADE 评分相比,ARC-HBR 标准对 ACS 患者 PCI 期间院内出血事件的预测能力更强。对 ARC-HBR 评分进行常规评估可能有助于识别这一特殊人群中的高危人群。
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来源期刊
IJC Heart and Vasculature
IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.90
自引率
10.30%
发文量
216
审稿时长
56 days
期刊介绍: IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.
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