Department of Cardiovascular Medicine, Fukushima Medical University.
Department of Clinical Laboratory Sciences, Fukushima Medical University School of Health Science.
Circ J. 2021 Dec 24;86(1):147-155. doi: 10.1253/circj.CJ-21-0686. Epub 2021 Oct 26.
It has recently been reported that the simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) definition, which excludes 6 rare criteria, is comparable to the original ARC-HBR definition in predicting major bleeding in patients with coronary artery disease (CAD) who undergo percutaneous coronary intervention. In this study, we investigated whether the simplified ARC-HBR definition could be applied to patients with heart failure (HF) to identify those at high bleeding risk (HBR).
In all, 2,437 patients hospitalized for HF were enrolled in this study. Patients were divided into 2 groups based on the simplified ARC-HBR definition: those at HBR (n=2,026; 83.1%) and those not (non-HBR group; n=411; 16.9%). The HBR group was older (72.0 vs. 61.0 years; P<0.001) and had a lower prevalence of CAD (31.1% vs. 36.5%; P=0.034) than the non-HBR group. Kaplan-Meier analysis showed that post-discharge bleeding events defined as hemorrhagic stroke or gastrointestinal bleeding were more frequent in the HBR than non-HBR group (log-rank P<0.001). The simplified ARC-HBR definition accurately predicted bleeding events (Fine-Gray model; hazard ratio 2.777, 95% confidence interval 1.464-5.270, P=0.001).
The simplified ARC-HBR definition predicts a high risk of bleeding events in patients with HF.
最近有报道称，排除 6 项罕见标准的简化学术研究联盟高出血风险（ARC-HBR）定义在预测接受经皮冠状动脉介入治疗的冠心病（CAD）患者的主要出血方面与原始 ARC-HBR 定义相当。在这项研究中，我们研究了简化的 ARC-HBR 定义是否可应用于心力衰竭（HF）患者，以确定那些具有高出血风险（HBR）的患者。
共纳入 2437 例因 HF 住院的患者。根据简化的 ARC-HBR 定义，患者分为 2 组：HBR 组（n=2026；83.1%）和非 HBR 组（n=411；16.9%）。HBR 组年龄较大（72.0 岁 vs. 61.0 岁；P<0.001），CAD 的患病率较低（31.1% vs. 36.5%；P=0.034）。Kaplan-Meier 分析显示，HBR 组比非 HBR 组出院后出血事件（定义为出血性卒中或胃肠道出血）更频繁（对数秩 P<0.001）。简化的 ARC-HBR 定义准确预测出血事件（Fine-Gray 模型；风险比 2.777，95%置信区间 1.464-5.270，P=0.001）。
简化的 ARC-HBR 定义预测 HF 患者出血事件风险较高。
