Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
J Cardiol. 2022 Aug;80(2):155-161. doi: 10.1016/j.jjcc.2022.02.018. Epub 2022 Mar 10.
The Academic Research Consortium for High Bleeding Risk (ARC-HBR) defined high bleeding risk (HBR) in patients undergoing percutaneous coronary intervention. We have reported a simplified HBR (S-HBR), excluding six items with prevalences under 1% from ARC-HBR. The Japanese Circulation Society developed an HBR specific to Japanese (J-HBR), adding three items to ARC-HBR in consideration of ethnicity. Data comparing each HBR are scarce.
Patients treated with second-generation drug-eluting stents between January 2010 and December 2013 were enrolled, in whom all items of ARC-HBR, and the incidences of major bleeding and ischemic events were examined. Also, the diagnostic values of ARC-HBR, S-HBR, and J-HBR at 1 and 7 years post procedure were compared by using receiver-operating characteristic curves.
The study sample consisted of 3430 patients. Mean follow-up period was 2299 ± 904 days. The incidence of major bleeding at 1 and 7 years in each definition was as follows: ARC-HBC, 3.3% and 10.6%; S-HBR, 3.3% and 10.7%; and J-HBR, 2.9% and 10.0%. The diagnostic value of J-HBR for major bleeding at 1 year was lower than that of ARC-HBR (C statistics 0.64 vs. 0.68, p < 0.001). Other diagnostic values of S-HBR and J-HBR were comparable to those of ARC-HBR.
S-HBR was as useful as ARC-HBR in predicting both short- and long-term HBR, and J-HBR is useful for predicting long-term HBR.
学术研究冠状动脉高出血风险联盟（ARC-HBR）定义了接受经皮冠状动脉介入治疗的患者的高出血风险（HBR）。我们已经报告了一种简化的 HBR（S-HBR），将 ARC-HBR 中六个患病率低于 1%的项目排除在外。日本循环学会开发了一种专门针对日本人的 HBR（J-HBR），考虑到种族因素，在 ARC-HBR 的基础上增加了三个项目。比较每种 HBR 的数据很少。
纳入 2010 年 1 月至 2013 年 12 月期间接受第二代药物洗脱支架治疗的患者，检查所有 ARC-HBR 项目、大出血和缺血性事件的发生率。还通过接受者操作特征曲线比较 ARC-HBR、S-HBR 和 J-HBR 在术后 1 年和 7 年的诊断价值。
研究样本包括 3430 例患者。平均随访时间为 2299±904 天。每种定义的 1 年和 7 年的大出血发生率如下：ARC-HBR，3.3%和 10.6%；S-HBR，3.3%和 10.7%；J-HBR，2.9%和 10.0%。J-HBR 在术后 1 年预测大出血的诊断价值低于 ARC-HBR（C 统计量为 0.64 与 0.68，p<0.001）。S-HBR 和 J-HBR 的其他诊断价值与 ARC-HBR 相当。
S-HBR 与 ARC-HBR 一样可用于预测短期和长期 HBR，J-HBR 可用于预测长期 HBR。
