Study Validates ARC High Bleeding Risk Definition in PCI Patients
The definition of high bleeding risk (HBR) that was recently proposed by the Academic Research Consortium (ARC) was found to be valid in a contemporary real-world group of patients who underwent PCI with stent implantation, according to a study published May 25 in the Journal of the American College of Cardiology.
Davide Cao, MD, et al., sought to validate ARC's recently proposed list of clinical criteria classified as either major or minor to define patients as HBR in patients who underwent PCI with stent implantation at a large volume tertiary-care center between 2014 and 2017. Researchers examined data from 9,623 patients. Of these patients, 4,278 (44%) qualified as HBR according to the ARC-HBR definition. Data showed that moderate or severe anemia was the most common major criterion (33.3%); and age ≥75 was the most frequent minor criterion and the most common overall (46.8%).
Researchers found that "the rate of the primary bleeding endpoint at 1 year in patients at HBR was higher than the 4% cutoff assumed by ARC-HBR consensus and nearly 3 times higher than in non-HBR patients." Results also showed that "the prognostic value of the ARC-HBR definition was further increased when the presence of multiple coexisting criteria was taken into account."
"The ARC-HBR definition, which is based on expert consensus after extensive review of published reports, promotes a more pragmatic approach to assessment of bleeding risk in PCI-treated patients," write the authors of the study. "Hence, our findings are essential to support the validity of this newly introduced definition of HBR and encourage its future application in clinical settings."
"Given the number of treatment options available to appropriately balance short- and long-term safety and efficacy in patients undergoing PCI, it is clear that the ARC-HBR criteria are practical and actionable, not just academic," write Sunil V. Rao, MD, FACC, and Zachary K. Wegermann, MD, in an accompanying editorial comment. "The clinician now has several strategies at his or her disposal to achieve the optimal balance between ischemic and bleeding risk in patients undergoing PCI."
Clinical Topics: Invasive Cardiovascular Angiography and Intervention
Keywords: Percutaneous Coronary Intervention, Tertiary Care Centers, Prognosis, Hemorrhage, Writing, Cardiology, Anemia, Stents
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