Temporal Trends of Major Bleeding and Its Prediction by the Academic Research Consortium-High Bleeding Risk Criteria in Acute Myocardial Infarction

Author:

Byun SungwookORCID,Choo Eun Ho,Oh Gyu-ChulORCID,Lim SungminORCID,Choi Ik JunORCID,Lee Kwan Yong,Lee Su NamORCID,Hwang Byung-Hee,Kim Chan Joon,Park Mahn-Won,Park Chul Soo,Kim Hee-Yeol,Yoo Ki-Dong,Jeon Doo Soo,Youn Ho Joong,Chung Wook Sung,Kim Min Chul,Jeong Myung Ho,Yim Hyeon-WooORCID,Ahn Youngkeun,Chang Kiyuk

Abstract

Limited data exist on the temporal trend of major bleeding and its prediction by the Academic Research Consortium-High Bleeding Risk (ARC-HBR) criteria in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). We investigated 10-year trends of major bleeding and predictive ability of the ARC-HBR criteria in AMI patients. In a multicenter registry of 10,291 AMI patients undergoing PCI between 2004 and 2014 the incidence of Bleeding Academic Research Consortium (BARC) 3 and 5 bleeding was assessed, and, outcomes in ARC-defined HBR patients with AMI were compared with those in non-HBR. The primary outcome was BARC 3 and 5 bleeding at 1 year. Secondary outcomes included all-cause mortality and composite of cardiovascular death, myocardial infarction, or ischemic stroke. The annual incidence of BARC 3 and 5 bleeding in the AMI population has increased over the years (1.8% to 5.8%; p < 0.001). At 1 year, ARC-defined HBR (n = 3371, 32.8%) had significantly higher incidence of BARC 3 and 5 bleeding (9.8% vs. 2.9%; p < 0.001), all-cause mortality (22.8% vs. 4.3%; p < 0.001) and composite of ischemic events (22.6% vs. 5.8%; p < 0.001) compared to non-HBR. During the past decade, the incidence of major bleeding in the AMI population has increased. The ARC-HBR criteria provided reliable predictions for major bleeding, mortality, and ischemic events in AMI patients.

Publisher

MDPI AG

Subject

General Medicine

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