CBS 2019
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中 文

科学研究

Abstract

Recommended Article

Patterns and associations between DAPT cessation and 2-year clinical outcomes in left main/proximal LAD versus other PCI: Results from the Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients (PARIS) registry Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study Complete Versus Culprit-Only Revascularization in STEMI: a Contemporary Review Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection Recurrent Cardiovascular Events in Survivors of Myocardial Infarction with St-Segment Elevation (From the AMI-QUEBEC Study) Aspirin-Free Prasugrel Monotherapy Following Coronary Artery Stenting in Patients With Stable CAD: The ASET Pilot Study Effect of Shorter Door-to-Balloon Times Over 20 Years on Outcomes of Patients With Anterior ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Original Research

JOURNAL:Circulation. Article Link

EUROPCR 2019 - ARC Defined High Bleeding Risk in PCI Patients

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Currently available bleeding risk scores are listed in Table 2. PRECISE-DAPT with Class IIb, Evidence A was recommended by ESC in 2017.

These risk scores were developed based on randomized trials with significant heterogeneity with respect to the patient population, such differences highlight the need for a standardized definition of HBR:

1. The differences in eligibility criteria (all-comer, patients at increased bleeding risk) and enrolled patient populations in completed trials are reflected in the differences in bleeding event rates, varies from 3.5-7.3%。

2. Patients unsuitable for long-term DAPT continue to be systematically excluded.

3. Clinical trials of DAPT strategies after stenting have also excluded patients at HBR, with reported major bleeding rates at 1 year varying between 0.3% and 2.8% (Table 1).

4. Subjects at HBR are still underrepresented in contemporary studies.




To optimize the identification and management of patients at high bleeding risk under going PCI, "Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention: A Consensus Document From the Academic Research Consortium for High Bleeding Risk" proposed the first pragmatic approach to a consistent definition of high bleeding risk in clinical trials evaluating the safety and effectiveness of devices and drug regimens for patients under going PCI. This white paper covers 20 criteria (14 major criteria and 6 minor criteria) which can assist clinicians identify patients with 1 major criterion or 2 minor criteria as high bleeding risk rapidly and make clinical decisions accordingly.