Background:Recently, the Academic Research Consortium for High Bleeding Risk (ARC-HBR) has been proposed to standardize the definition of HBR, which was arbitrarily defined as a Bleeding Academic Research Consortium 3 or 5 bleeding ≥4% at 1-year. However, the prevalence and the expected bleeding event rate of HBR patients defined by ARC-HBR criteria are currently unknown in the real-world percutaneous coronary intervention practice.Methods:We applied the ARC-HBR criteria in the CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort-2, a multicenter registry that enrolled 13 058 consecutive patients who underwent their first percutaneous coronary intervention. The primary bleeding end point was defined as the Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries moderate/severe bleeding. There were 5570 patients (43%) in the HBR group and 7488 patients in the no-HBR group.Results:Cumulative incidence of the primary bleeding end point was much higher in the HBR group than in the no-HBR group (10.4% versus 3.4% at 1-year, and 18.9% versus 6.6% at 5-year, P<0.0001). Presence of each ARC-HBR major or even minor criterion, in isolation, with the exception of liver cirrhosis and prior ischemic stroke, was also associated with major bleeding risk higher than 4% at 1-year. Cumulative 5-year incidence of the primary bleeding end point got incrementally higher as the number of the ARC-HBR major criteria increased (≥3 majors: 49.9%, 2 majors: 30.6%, 1 major: 18.5%, ≥2 minors: 14.7%, and no-HBR: 6.6%, P<0.0001).Conclusions:ARC-HBR criteria successfully identified those patients with very HBR after percutaneous coronary intervention, who represented 43% of patients in this all-comers registry.

中文翻译：

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学术研究协会高出血风险标准在经皮冠状动脉介入治疗的所有登记册中的应用。

背景：最近，高出血风险学术研究联盟（ARC-HBR）提出了标准化HBR的定义，该定义被任意定义为1年内出血学术研究联盟3或5出血≥4％。然而，目前在现实的经皮冠状动脉介入治疗实践中尚不清楚由ARC-HBR标准定义的HBR患者的患病率和预期的出血事件发生率。 《京都府结局研究》登记册队列2，这是一个多中心登记册，招募了13 058名连续接受首次冠状动脉介入治疗的患者。主要的出血终点被定义为阻塞性冠状动脉中度/重度出血的链激酶和组织纤溶酶原激活物的整体利用。HBR组有5570例患者（43％），no-HBR组有7488例患者。结果：HBR组的原发性出血终点的累积发生率比no-HBR组要高得多（10.4％ 1年期为3.4％，5年期为6.8.9％，而18.9％，P <0.0001）。除肝硬化和先前的缺血性卒中外，每个ARC-HBR主要或次要标准的存在也与1年时高于4％的大出血风险相关。随着ARC-HBR主要标准数量的增加，五年级原发性出血终点的累积发生率逐渐升高（≥3个专业：49.9％，2个专业：30.6％，1个专业：18.5％，≥2个未成年人：14.7 ％，无HBR：6.6％，P <0.0001）。结论：ARC-HBR标准成功识别了经皮冠状动脉介入治疗后HBR很高的患者，在所有患者中占43％。