Highlights
- •Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria are widely used to identify high bleeding risk patients.
- •We stratified patients with acute coronary syndrome according to ARC-HBR score.
- •High ARC-HBR score was associated with major adverse cardiovascular events (MACE).
- •ARC-HBR score had a reasonable diagnostic ability for predicting long-term MACE.
Abstract
Background
Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria have been used
to identify high-risk patients undergoing percutaneous coronary intervention (PCI)
in current clinical practice. This study aimed to evaluate the association between
the number of ARC-HBR criteria and clinical outcomes in patients with acute coronary
syndrome (ACS) after an emergent PCI.
Methods
We assessed 338 consecutive patients with ACS who underwent successful emergent PCI
between January 2017 and December 2020. The ARC-HBR score was calculated by assigning
1 point to each major criterion and 0.5 points to each minor criterion. The patients
were classified into low (ARC-HBR score < 1), intermediate (1 ≤ ARC-HBR score < 2), and high (ARC-HBR score ≥ 2) bleeding risk groups. We investigated the association between the ARC-HBR score
and major adverse cardiovascular events (MACEs), defined as a composite of all-cause
death, non-fatal myocardial infarction, and non-fatal stroke. We also compared the
diagnostic ability of the ARC-HBR score and Controlled Abciximab and Device Investigation
to Lower Late Angioplasty Complications (CADILLAC) risk score.
Results
The mean age of the patients was 67.6 ± 12.4 years, and 78.4 % were men. During the median follow-up of 864 (557–1309) days, 70 patients developed
MACEs. Kaplan–Meier curves showed that the cumulative incidence of MACE was significantly
higher as the ARC-HBR score increased in a stepwise manner (log-rank p < 0.001). There were no significant differences in the area under the receiver operating
characteristic curve (AUC) for predicting MACE within two years after an emergent
PCI between the ARC-HBR and CADILLAC risk scores (AUC: 0.763 vs. 0.777).
Conclusions
ARC-HBR score was independently associated with an increased risk of MACE in patients
with ACS after an emergent PCI. Moreover, it had a similar diagnostic ability for
predicting MACE within two years compared to the CADILLAC risk score.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 28, 2023
Accepted:
December 15,
2022
Received in revised form:
November 21,
2022
Received:
July 25,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
