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-048

Validation of Academic Research Consortium for High Bleeding Risk Definition in East-Asian Patients

By Jinho Lee, Hoyun Kim, Yeonwoo Choi, Do-Yoon Kang, Jung-Min Ahn, Seung-Jung Park, Duk-Woo Park

Presenter

Jinho Lee

Authors

Jinho Lee1, Hoyun Kim1, Yeonwoo Choi1, Do-Yoon Kang1, Jung-Min Ahn1, Seung-Jung Park1, Duk-Woo Park1

Affiliation

Asan Medical Center, Korea (Republic of)1
View Study Report
TCTAP A-048
Pharmacology/Pharmacotherapy

Validation of Academic Research Consortium for High Bleeding Risk Definition in East-Asian Patients

Jinho Lee1, Hoyun Kim1, Yeonwoo Choi1, Do-Yoon Kang1, Jung-Min Ahn1, Seung-Jung Park1, Duk-Woo Park1

Asan Medical Center, Korea (Republic of)1

Background

Clinical  applicability of the Academic Research Consortium High Bleeding Risk (ARC-HBR)criteria in East-Asian patients receiving potent antiplatelet therapy for acutecoronary syndromes (ACS) is still undetermined.

Methods

We analyzed data from the TICAKOREA trial, randomly assigned 800 Korean ACS subjects to receive, in a 1:1 ratio, ticagrelor or clopidogrel. Patients were considered HBR if they met at least one major or two minor ARC-HBR criteria. The primary bleeding endpoint was Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding and the primary ischemic endpoint was a major adverse cardiovascular event (MACE; a composite of cardiovascular death, myocardial infarction, or stroke) at 12 months.

Results

Among 800 randomized patients, 129 (16.3%) were categorized HBR patients. HBR patients, compared to non-HBR patients, had a higher incidence of BARC 3 or 5 bleeding (10.0% vs. 3.7%; hazard ratio [HR], 2.98; 95%confidence interval [CI], 1.52–5.86; P < 0.001) and MACE (14.3% vs. 6.1%;HR 2.35; 95% CI, 1.35–4.10; P = 0.002). The relative treatment effect of ticagrelor or clopidogrel on primary bleeding and ischemic outcomes were different between each group.


Conclusion

This study validates the ARC-HBR definition in Korean ACS patients. Approximately 15% of patients qualified as HBR patients who were at increased risk not only for bleeding but also for thrombotic events.The clinical application of ARC-HBR to determine the relative effect of different antiplatelet regiments should be further investigated

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