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The Bleeding Academic Research Consortium (BARC) definition of bleeding was suggested to be a predictive value in regard to 1-year mortality that is comparable to that provided by traditional bleeding definitions. We evaluated for clinical utility of the new bleeding criteria, proposed by BARC, compared with old criteria after percutaneous coronary intervention (PCI) in clinical routine.
We prospectively recruited 375 consecutive patients underwent PCI between June 2012 and September 2012 at Dong-A university hospital in Korea. In this study, the bleeding complications as defined by BARC and traditional bleeding criteria, the Thrombolysis in Myocardial Infarction (TIMI) and Global Use of Strategies To Open coronary arteries (GUSTO), were investigated in all patients undergoing PCI. The primary outcome was bleeding events that requiring significant medical care including endoscopic procedure, emergency operation, or blood transfusion. We compared the utility of bleeding definitions in real-world clinical practice.
Total bleeding events occurred in 43 patients (11.5%). Twenty patients (5.3%) required significant medical care. The kinds of bleeding were hematoma or oozing in puncture site (7.2%), gastrointestinal bleeding (1.9%), gross hematuria (2.4%), upper airway bleeding (0.5%), and pericardial effusion (0.5%). BARC class ≥2 bleeding occurred in 27 patients (7.2%). However, TIMI major or minor bleeding and GUSTO moderate or severe bleeding occurred in 5 (1.3%) and 10 patients (2.6%), respectively. On receiver-operating characteristic curve analysis, bleeding defined BARC class ≥2 effectively predicted significant medical care with a sensitivity of 100% and a specificity of 69.6% (p <0.001) than TIMI (p = 0.016, sensitivity, 25%; specificity, 100%; accuracy, 65%) or GUSTO (p <0.001; sensitivity, 50%; specificity, 100%; accuracy, 76.7%) bleeding criteria.
New bleeding definition, proposed by BARC, provided valuable information associated bleeding complications after PCI and might be useful for clinical decision requiring medical care in real world clinical practice.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Bleeding and ACS: Predicting Risk and Measuring Impact
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1215M-199
- 2013 American College of Cardiology Foundation