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Performance of bleeding risk scores in patients with acute coronary syndrome
Session:
Posters - E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Speaker:
João Presume
Congress:
CPC 2021
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Posters
FP Number:
---
Authors:
João Presume; Daniel Gomes; Francisco Albuquerque; Carlos Aguiar; Marisa Trabulo; Pedro de Araújo Gonçalves; Rui Campante Teles; Manuel Almeida; Miguel Mendes; Jorge Santos Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><u>Background:</u></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif">Treatment for acute coronary syndrome (ACS) reduces the risk of ischemic events. Several bleeding risk scores have been proposed to stratify and individualize antithrombotic therapy. The aim of this study was to compare the performance of the ARC-HBR, CRUSADE, ACUITY-HORIZONS, PARIS and PRECISE-DAPT risk scores in a population of patients with ACS. </span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><u>Methods:</u></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif">We conducted a single-center retrospective study enrolling consecutive patients admitted for ACS, from January 2016 to December 2018. Risk scores were calculated based on the demographic and clinical patient’s characteristics. One-year bleeding events were assessed using BARC (Bleeding Academic Research Consortium) classification.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><u>Results:</u></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif">A total of 515 patients (mean age 65 ±14 years, 72% male) were included in the analysis. A total of 58 hemorrhagic events occurred during the first year of follow-up: 33 BARC 3a (56.9%), 23 BARC 3b (39.7%), 1 BARC 3c (1.7%), and 1 BARC 5 (1.7%). Most bleeding events occurred in the first 30 days (83%). Rates of bleeding events (BARC ≥ 3a) for each risk group are represented in figure 1a. In the C-Statistic analysis, discrimination of ARC-HBR and CRUSADE was good (AUC 0.777, and 0.697 respectively), but poor in the other risk scores (AUC ACUITY-HORIZONS 0.645; AUC PRECISE-DAPT 0.644; AUC PARIS 0.625). The discriminative ability of ARC-HBR was superior to ACUITY-HORIZONS, PRECISE-DAPT, and PARIS (z=2.330 - p=0.020; z=2.363 - p=0.018; z=2.741 - p=0.006; respectively) but not significantly different in comparison to CRUSADE (z=1.465, p=0.143). No significant differences were found between the other models. </span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><u>Conclusion:</u></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif">The great majority of bleeding events occurred in the first 30 days after admission acute coronary syndrome. Our findings suggest that ARC-HBR bleeding risk score performs better than most other bleeding risk scores. </span></span></p>
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