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Late Survival Benefit of Percutaneous Coronary Intervention Compared With Medical Therapy in Patients With Coronary Chronic Total Occlusion: A 10-Year Follow-Up Study 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Decreased inspired oxygen stimulates de novo formation of coronary collaterals in adult heart Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery Impact of Off-Hours Versus On-Hours Primary Percutaneous Coronary Intervention on Myocardial Damage and Clinical Outcomes in ST-Segment Elevation Myocardial Infarction Effect of Smoking on Outcomes of Primary PCI in Patients With STEMI High-Sensitivity Troponin I Levels and Coronary Artery Disease Severity, Progression, and Long-Term Outcomes Coronary Artery Disease in Patients With Out-of-Hospital Refractory Ventricular Fibrillation Cardiac Arrest
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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.







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