E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-088

Validation of ARC-HBR Criteria for Patients Undergoing Percutaneous Coronary Intervention in Thai Population

By Donluck Poonkasem, Krissada Meemook

Presenter

Donluck Poonkasem

Authors

Donluck Poonkasem1, Krissada Meemook1

Affiliation

Ramathibodi Hospital, Thailand1
View Study Report
TCTAP A-088
Quality, Guidelines and Appropriateness Criteria

Validation of ARC-HBR Criteria for Patients Undergoing Percutaneous Coronary Intervention in Thai Population

Donluck Poonkasem1, Krissada Meemook1

Ramathibodi Hospital, Thailand1

Background

        Recognizing a lack of consensus definition used in identifying patients at high bleeding risk undergoing percutaneous coronary intervention (PCI), the Academic Research Consortium for High Bleeding Risk (ARC-HBR) published a new set of criteria to define this population in 2019. This study aims to validate this new definition for its risk screening capability in Thai population.

Methods

        This retrospective cohort study applied the ARC-HBR high bleeding risk (HBR) definition to consecutive patients undergoing PCI in Ramathibodi Hospital between June 1st, 2019 and December 31st, 2019. Patients were diagnosed with HBR if at least one major or two minor criteria were met, and they were then followed for a year. The primary outcome of this study was the risk of Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding at 1-year. Additionally, secondary outcomes were also evaluated, including the risk of gastrointestinal (GI) bleeding and ischemic outcomes—cardiovascular death, recurrent myocardial infarction (MI), and stent thrombosis.

Results

        The study included 419 PCI patients (68.6 ± 12.6-year-old, 65.9% male). Two hundred and one (48%) patients identified as HBR had an increased risk of BARC 3 or 5 bleeding (10.45% vs. 3.67%; p = 0.011) and GI bleeding (6.97% vs. 1.38%; p = 0.008). There was no statistical difference among ischemic outcomes; cardiovascular death (3.48% vs. 1.38%; p = 0.21), recurrent MI (3.98% vs. 5.96%; p = 0.48), and stent thrombosis (1% vs. 1.83%; p = 0.68). The ROC curve indicated that the sensitivity of ARC-HBR is 70%, whereas the specificity is 53.3%.


Conclusion

        The ARC-HBR criteria were successful in identifying patients with an increased risk of 1-year major (BARC 3 or 5) bleeding events in our study cohort of Thai patients undergoing PCI. This HBR definition could be used to help identify patients at high risk of bleeding, allowing doctors to prescribe appropriate types, doses, and durations of antiplatelets.

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