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Practical Assessment of the Tradeoff between Fatal Bleeding and Coronary Thrombotic Risks using the Academic Research Consortium for High Bleeding Risk Criteria
- Source :
- Journal of atherosclerosis and thrombosis. 29(8)
- Publication Year :
- 2021
-
Abstract
- Aims We aimed to establish a practical method for the assessment of tradeoff between thrombotic and bleeding risks. Methods We aimed to investigate the balance between bleeding risk and coronary thrombotic risk according to the number of the Academic Research Consortium for high bleeding risk (ARC-HBR) criteria in the multicenter prospective ST/non-ST elevation myocardial infarction (STEMI/NSTEMI) registry (N=12,093). Patients were divided as follows by the number of ARC-HBR criteria fulfilled: group 0, 0 major with ≤ 1 minor (N=6,792); group 1, 1 major with 0 minor (N=1,705); group 2, 0 major with ≥ 2 minors (N=790); group 3, 1 major with ≥ 1 minor (N=1,709); group 4, 2 majors with ≥ 0 minors (N=861); and group 5, ≥ 3 majors with ≥ 0 minor (N=236). We assessed the acute-phase absolute risk differences between bleeding and coronary thrombotic events in each group. Results At 7-day follow-up, all patients (groups 0-5) had a higher risk of major bleeding than that of any myocardial infarction (MI). Patients at ARC-HBR (groups 1-5) had a balanced risk between fatal MI and fatal bleeding, whereas patients at non-ARC-HBR (group 0) had a higher risk of fatal MI than that of fatal bleeding. Conclusions All STEMI/NSTEMI patients have a relatively high risk of major bleeding as compared with the risk of any MI in the acute phase. The ARC-HBR criteria would be a practical tool for assessing the tradeoff between fatal bleeding and fatal MI risks. This practical assessment would be helpful for the optimal decision-making of appropriate treatment strategy considering the balance between bleeding and coronary thrombotic risks.
- Subjects :
- medicine.medical_specialty
Myocardial Infarction
Hemorrhage
Risk Assessment
Percutaneous Coronary Intervention
Risk Factors
Internal medicine
Internal Medicine
medicine
Humans
Myocardial infarction
Prospective Studies
Non-ST Elevated Myocardial Infarction
Risk criteria
Thrombotic risk
business.industry
Biochemistry (medical)
Absolute risk reduction
Thrombosis
medicine.disease
Treatment Outcome
Treatment strategy
ST Elevation Myocardial Infarction
Cardiology and Cardiovascular Medicine
business
Major bleeding
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 18803873
- Volume :
- 29
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of atherosclerosis and thrombosis
- Accession number :
- edsair.doi.dedup.....a7962666ac6cd0ddf6238c9c4372baec