2. Department of Cardiology, Bern University Hospital, Bern, Switzerland, Switzerland
3. Institute of Social and Preventive Medicine and Clinical Trials Unit, University of Bern, Bern, Switzerland.
As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received. The content of this article is the sole responsibility of the authors, and not that of the journal or its publishers.
Please note that supplementary movies are not available online at this stage. Once a paper is published in its edited and formatted form, it will be accompanied online by any supplementary movies.
To read the full content of this article, please download the PDF. Download full article (PDF)
Sign in to read and download the full articleForgot your password?
Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com
Methods and results: Between 2009 and 2016, patients undergoing PCI were prospectively included in the Bern PCI Registry. Patients were considered to be at HBR if at least 1 major criterion or 2 minor criteria were met. The primary endpoint was Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding at 1 year; ischemic outcomes were assessed using the device-oriented composite endpoints (DOCE) of cardiac death, target-vessel myocardial infarction, and target lesion revascularization. Among 12,121 patients, those at HBR (n=4,781, 39.4%) had an increased risk of BARC 3 or 5 bleeding (6.4% vs. 1.9%; P<0.001) and DOCE (12.5% vs. 6.1%; P<0.001) compared with those without HBR. The degree of risk and prognostic value was related to the risk factors composing the criteria. The ARC-HBR criteria had higher sensitivity than PRECISE-DAPT score and PARIS bleeding risk score (63.8%, 53.1%, 31.9%), but lower specificity (62.7%, 71.3%, 86.5%) for BARC 3 or 5 bleeding.
Conclusions: Patients at HBR defined by the ARC-HBR criteria had a higher risk of BARC 3 or 5 bleeding as well as DOCE. The bleeding risk was related to its individual components. The ARC-HBR criteria was more sensitive to identify patients with future bleedings than other contemporary risk scores at the cost of specificity.