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

• Published in: Journal of clinical medicine Vol. 11; no. 4; p. 988
• Main Authors: Byun, Sungwook, Choo, Eun Ho, Oh, Gyu-Chul, Lim, Sungmin, Choi, Ik Jun, Lee, Kwan Yong, Lee, Su Nam, 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-Woo, Ahn, Youngkeun, Chang, Kiyuk
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.02.2022; MDPI
• Subjects: acute myocardial infarction; Angina pectoris; Aspirin; bleeding risk; Clinical medicine; Clinical outcomes; Consortia; Coronary vessels; Heart attacks; Mortality; percutaneous coronary intervention; Population; Risk factors; Stroke; Trends; Vein & artery diseases; South Korea; bleeding risk; percutaneous coronary intervention; acute myocardial infarction
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11040988

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%; < 0.001). At 1 year, ARC-defined HBR ( = 3371, 32.8%) had significantly higher incidence of BARC 3 and 5 bleeding (9.8% vs. 2.9%; < 0.001), all-cause mortality (22.8% vs. 4.3%; < 0.001) and composite of ischemic events (22.6% vs. 5.8%; < 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.