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The proper management of bleeding risk in patients undergoing percutaneous coronary intervention (PCI) is critical. Recently, the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria have been proposed as a standardized tool for predicting bleeding risk. We sought to compare the predictive performance of ARC-HBR criteria and the PRECISE-DAPT score for bleeding in Korean patients undergoing PCI. We recruited 1418 consecutive patients undergoing PCI from January 2012 through December 2018 (Dong-A University Medical Center, Busan, Korea). The ARC-HBR and PRECISE-DAPT scores showed a high AUC for three bleeding definitions (AUC 0.75 and 0.77 for BARC 3 to 5; AUC 0.68 and 0.71 for TIMI minor to major; AUC 0.81 and 0.82 for GUSTO moderate to severe, respectively) and all-cause death (AUC 0.82 and 0.82, respectively). When compared with the ARC-HBR score, the discriminant ability of the PRECISE-DAPT score was not significantly different for bleeding events and all-cause death. The ARC-HBR criteria and PRECISE-DAPT scores demonstrated reasonably good discriminatory capacity with respect to 1-year bleeding events in Korean patients treated with DAPT, regardless of the bleeding definition. Our findings also suggest that the simple PRECISE-DAPT score is as useful as ARC-HBR criteria in predicting bleeding and all-cause death after PCI.
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http://dx.doi.org/10.3390/jcm10122566 | DOI Listing |
JACC Cardiovasc Interv
August 2025
Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France; Hanoï Medical University, Vietnam. Electronic address:
Background: Acquired von Willebrand factor (vWF) deficiency is a key contributor to bleeding after transcatheter aortic valve replacement (TAVR).
Objective: To evaluate whether assessing primary hemostatic disorder using closure time of adenosine diphosphate (CT-ADP), a marker of vWF dysfunction, enhances bleeding risk stratification in TAVR patients at high bleeding risk (HBR).
Methods: We analyzed 884 patients from a prospective TAVR registry.
Background: Although it is well-known that patients with high bleeding risk (HBR) who undergo percutaneous coronary intervention (PCI) have poor clinical outcomes, the details have not been fully clarified for acute coronary syndrome (ACS) population. The aim of this study was to describe patient and lesion characteristics in patients with ACS and HBR as defined by the Academic Research Consortium (ARC).
Methods: Patients with ACS (n=961) who underwent optical coherence tomography (OCT)-guided PCI were investigated.
BMC Cardiovasc Disord
May 2025
Division of Cardiology, Shimane Prefectural Central Hospital, Izumo, Japan.
Background: The differentiation of the Academic Research Consortium high bleeding risk (HBR) (ARC-HBR) criteria and those modified for Japanese patients (J-HBR) for predicting events following discharge in patients with acute coronary syndrome (ACS) has yet to be clarified. In this study, we compared the ARC-HBR and J-HBR criteria for predicting post-discharge bleeding and associated events in patients with ACS.
Methods: We retrospectively analyzed data from 889 patients with ACS discharged alive at two tertiary hospitals in Japan between August 2009 and July 2018.
Cardiovasc Drugs Ther
April 2025
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea.
Purpose: Proton pump inhibitors (PPIs) are effective in preventing gastrointestinal (GI) bleeding in high-risk patients on dual antiplatelet therapy (DAPT). Existing criteria for high GI bleeding risk, such as those from the American Heart Association (AHA), may not fully reflect East Asian patient profiles. This study aimed to evaluate the effectiveness of PPIs in preventing GI bleeding across DAPT combinations, stratified by GI bleeding risk using the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria in patients with acute coronary syndrome (ACS).
View Article and Find Full Text PDFThromb Haemost
March 2025
Department of Cardiology, State Key Laboratory of Frigid Zone Cardiovascular Disease, General Hospital of Northern Theater Command, Shenyang, China.
This study aimed to evaluate the impact of systemic inflammation burden using high-sensitivity C-reactive protein (hsCRP) and long-term prognosis in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) stratified by bleeding risk status.Consecutive patients admitted for ACS and who received PCI between March 2016 and March 2022 were enrolled in the analysis. Elevated systemic inflammation was defined as hsCRP >2 mg/L, and high bleeding risk (HBR) was defined the Academic Research Consortium (ARC)-HBR criteria.
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