@article{d87d0e63c8bd457c9f2a8ad708cf5b07,
title = "Performance of the academic research consortium high-bleeding risk criteria in patients undergoing PCI for acute myocardial infarction",
abstract = "Abstract: Patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) are at increased risk for thrombotic and bleeding complications compared to patients with chronic coronary syndrome (CCS). The academic research consortium (ARC) recently suggested a set of criteria to identify patients at high bleeding risk (HBR). We sought to evaluate the performance of the ARC-HBR criteria among patients undergoing PCI according to clinical presentation. We included all consecutive patients undergoing PCI at a tertiary-care center. Patients were deemed at HBR if they fulfilled ≥ 1 major or ≥ 2 minor ARC-HBR criteria. The primary bleeding endpoint was a composite of in-hospital or post-discharge bleeding at 1-year follow-up. Secondary outcomes included all-cause death and myocardial infarction. Out of 6068 patients, 1391 (22.9 %) presented with AMI and were more often at HBR than those with CCS (46.9 % vs. 43.0 %, p = 0.01). HBR patients had a higher risk for the primary bleeding endpoint than non-HBR, irrespective of the clinical indication for PCI (AMI: 19.5 % vs. 5.5 %; HR 3.86, 95 % CI 2.63–5.69; CCS: 6.8 % vs. 2.6 %; HR 2.65, 95 % CI 1.92–3.68; p-interaction = 0.11). Secondary outcomes followed a similar trend. After multivariable adjustment, AMI presentation remained significantly associated with increased risk for bleeding at 1 year (HR 1.64, 95 % CI 1.13–2.38, p = 0.01). The ARC-HBR criterion associated with the highest bleeding risk was severe/end-stage chronic kidney disease in AMI and moderate/severe anemia in CCS. The ARC-HBR framework successfully identified AMI and CCS patients with increased risk for bleeding complications at 1 year post-PCI. Graphical abstract: [Figure not available: see fulltext.]",
keywords = "ARC-HBR, High bleeding risk, Percutaneous coronary intervention",
author = "Johny Nicolas and Frans Beerkens and Davide Cao and Samantha Sartori and Pivato, {Carlo Andrea} and Hanbo Qiu and Gennaro Giustino and Mauro Chiarito and Claessen, {Bimmer E.} and Zhongjie Zhang and Matteo Nardin and Victor Razuk and Davis Jones and Anton Camaj and David Power and Bryana Banashefski and Joseph Sweeny and Usman Baber and George Dangas and Sharma, {Samin K.} and Annapoorna Kini and Roxana Mehran",
note = "Funding Information: Usman Baber reports speaker honoraria from AstraZeneca and Boston Scientific. George Dangas reports institutional research grants from Abbott Laboratories, AstraZeneca, Bayer, Boston Scientific, Medtronic, and Daiichi-Sankyo; consultant fees from Biosensors, Boston Scientific, and speaker honoraria from Chiesi. Samin K Sharma reports consulting fees or honoraria from Abbott, Boston Scientific, Abiomed, and Cardiovascular System Inc. Roxana Mehran reports institutional research grants from Abbott Laboratories, Abiomed, Applied Therapeutics, AstraZeneca, Bayer, Beth Israel Deaconess, Bristol-Myers Squibb, CERC, Chiesi, Concept Medical, CSL Behring, DSI, Medtronic, Novartis Pharmaceuticals, OrbusNeich, Zoll; consultant fees from Boston Scientific, Cine-Med Research, Janssen Scientific Affairs, Medscape/WebMD; consultant fees paid to the institution from Abbott Laboratories, Abiomed (spouse), Bayer (spouse), Beth Israel Deaconess, Bristol-Myers Squibb, CardiaWave, Chiesi, Concept Medical, DSI, Duke University, Idorsia Pharmaceuticals, Medtronic, Novartis, Spectranetics/Philips/Volcano Corp; Equity < 1 The other authors declare that there is no conflict of interest. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
year = "2021",
doi = "https://doi.org/10.1007/s11239-021-02534-z",
language = "English",
journal = "Journal of Thrombosis and Thrombolysis",
issn = "0929-5305",
publisher = "Springer Netherlands",
}