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Validation of the a...
Validation of the academic research consortium high bleeding risk criteria in patients undergoing percutaneous coronary intervention : A systematic review and meta-analysis of 10 studies and 67,862 patients
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- Silverio, Angelo (author)
- Univ Salerno, Dept Med Surg & Dent, Salerno, Italy.
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- Di Maio, Marco (author)
- Univ Salerno, Dept Med Surg & Dent, Salerno, Italy.
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- Buccheri, Sergio (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- De Luca, Giuseppe (author)
- Azienda Osped Univ Maggiore Carita, Eastern Piedmont Univ, Div Cardiol, Novara, Italy.
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- Esposito, Luca (author)
- Univ Salerno, Dept Med Surg & Dent, Salerno, Italy.
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- Sarno, Giovanna (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Vecchione, Carmine (author)
- Univ Salerno, Dept Med Surg & Dent, Salerno, Italy.;IRCCS Neuromed, Vasc Pathophysiol Unit, Pozzilli, Isernia, Italy.
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- Galasso, Gennaro (author)
- Univ Salerno, Dept Med Surg & Dent, Salerno, Italy.
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Univ Salerno, Dept Med Surg & Dent, Salerno, Italy Kardiologi (creator_code:org_t)
- Elsevier, 2022
- 2022
- English.
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In: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 347, s. 8-15
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background: To assess the performance of the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria in stratifying the risk of bleeding and ischaemic events after percutaneous coronary intervention (PCI).Methods: MEDLINE, COCHRANE, Web of Sciences, and SCOPUS were searched for studies aimed at validating the ARC-HBR criteria in patients treated with PCI. The primary outcome measure of this meta-analysis was major bleeding.Results: The analysis included 10 studies encompassing 67,862 patients undergoing PCI; the HBR definition was fulfilled in 44.7% of the cases. The risk of major bleeding was significantly higher in HBR vs. Non-HBR group (RR, 2.56, 95% CI 2.28-2.89). The average C-statistic was 0.64 (95% CI 0.60-0.68), indicating modest discrimination. The risk of intracranial hemorrhage, gastrointestinal bleeding, fatal bleeding, ischaemic stroke, cardiac death and all-cause death was higher in HBR vs. Non-HBR group. Despite a higher incidence of myocardial infarction and stent thrombosis in patients deemed at HBR, the rate of target lesion revascularization was comparable between groups (RR, 1.01, 95% CI 0.88-1.16). The mean effect size for the cumulative incidence of major bleeding exceeded the HBR cut-off value of 4% for all major criteria except one, and for two out of six minor criteria, namely age >= 75 years and moderate CKD.Conclusion: The ARC-HBR definition identifies patients at higher risk of major bleeding and other adverse cardiovascular events after PCI. Almost all major criteria, but also two of the minor criteria, were individually associated with rates of major bleeding above 4% thus fulfilling the definition of major HBR criteria.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Percutaneous coronary intervention
- Bleeding
- Risk assessment
- Prediction model
- Myocardial infarction
- Outcome
Publication and Content Type
- ref (subject category)
- for (subject category)
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