Choi Sun Young, Kim Moo-Hyun, Lee Kwang-Min, Ko Yeo-Gyeong, Yoon Chan-Ho, Jo Min-Kyeong, Yun Sung-Cheol
Department of Cardiology, Dong-A University Hospital, Busan 49201, Korea.
Department of Biomedical Laboratory Science, Daegu Health College, Daegu 41453, Korea.
J Clin Med. 2021 Jun 10;10(12):2566. doi: 10.3390/jcm10122566.
The proper management of bleeding risk in patients undergoing percutaneous coronary intervention (PCI) is critical. Recently, the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria have been proposed as a standardized tool for predicting bleeding risk. We sought to compare the predictive performance of ARC-HBR criteria and the PRECISE-DAPT score for bleeding in Korean patients undergoing PCI. We recruited 1418 consecutive patients undergoing PCI from January 2012 through December 2018 (Dong-A University Medical Center, Busan, Korea). The ARC-HBR and PRECISE-DAPT scores showed a high AUC for three bleeding definitions (AUC 0.75 and 0.77 for BARC 3 to 5; AUC 0.68 and 0.71 for TIMI minor to major; AUC 0.81 and 0.82 for GUSTO moderate to severe, respectively) and all-cause death (AUC 0.82 and 0.82, respectively). When compared with the ARC-HBR score, the discriminant ability of the PRECISE-DAPT score was not significantly different for bleeding events and all-cause death. The ARC-HBR criteria and PRECISE-DAPT scores demonstrated reasonably good discriminatory capacity with respect to 1-year bleeding events in Korean patients treated with DAPT, regardless of the bleeding definition. Our findings also suggest that the simple PRECISE-DAPT score is as useful as ARC-HBR criteria in predicting bleeding and all-cause death after PCI.
对接受经皮冠状动脉介入治疗(PCI)的患者进行出血风险的恰当管理至关重要。最近,高出血风险学术研究联盟(ARC-HBR)标准已被提议作为预测出血风险的标准化工具。我们试图比较ARC-HBR标准和PRECISE-DAPT评分对韩国接受PCI患者出血情况的预测性能。我们招募了2012年1月至2018年12月期间在韩国釜山的东国大学医学中心连续接受PCI的1418例患者。对于三种出血定义(BARC 3至5级时AUC分别为0.75和0.77;TIMI轻微至严重时AUC分别为0.68和0.71;GUSTO中度至重度时AUC分别为0.81和0.82)以及全因死亡(AUC均为0.82),ARC-HBR和PRECISE-DAPT评分均显示出较高的曲线下面积(AUC)。与ARC-HBR评分相比,PRECISE-DAPT评分对出血事件和全因死亡的判别能力无显著差异。对于接受双联抗血小板治疗(DAPT)的韩国患者,无论出血定义如何,ARC-HBR标准和PRECISE-DAPT评分在预测1年出血事件方面均表现出相当好的判别能力。我们的研究结果还表明,简单的PRECISE-DAPT评分在预测PCI术后出血和全因死亡方面与ARC-HBR标准同样有用。