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June 29, 2022Circulation Reports6 citationsOpen Access

Correlation Between the Japanese Version of the High Bleeding Risk (J-HBR) Criteria and the PRECISE-DAPT Score, and Optimal J-HBR Cut-Off Score to Predict Major Bleeding

NKNaoki KubotaKOKazuyuki OzakiTATakumi Akiyama

Key Result

A modified Japanese version of the High Bleeding Risk (J-HBR) score ≥1.5 significantly predicted major bleeding at 1 year (HR 3.81) without an increased risk of ischemic events.

Study Design

Type

Observational (n=842)

Multicenter

No

Structured PICO

Does the J-HBR score correlate with the PRECISE-DAPT score and predict major bleeding and ischemic events in patients undergoing PCI?

P
Population
842 patients (mean age 70 years, 25% female) who underwent percutaneous coronary intervention, followed for 1 year to evaluate bleeding and ischemic risk scores.
E
Exposure
Bleeding risk assessment using the Japanese version of high bleeding risk (J-HBR) criteria (and a modified J-HBR score cutoff of ≥1.5).
C
Comparator
Bleeding risk assessment using the PRECISE-DAPT score.
O
Outcome
Major bleeding (Bleeding Academic Research Consortium [BARC] Type 3 or 5) and ischemic events (myocardial infarction and ischemic stroke) within 1 year after PCI.safety

A modified J-HBR score cutoff of ≥1.5 identifies patients at high bleeding risk without an increased risk of ischemic events, offering a potential tool for tailoring antithrombotic therapy post-PCI.

Main Result

Hazard Ratio: 3.81 (95% CI 1.43–10.15)

p-value: p=0.007

Limitations

  • Small sample size
  • Single-center study
  • Retrospective design leading to missing data on some J-HBR major criteria (frailty, chronic bleeding diathesis, non-deferrable major surgery)
  • Bleeding events from access sites were excluded
  • Detailed data on DAPT duration not available
  • Duration of antithrombotic therapy differed from current guidelines
  • Exclusion of access site bleeding events
  • Lack of detailed data on DAPT duration

Abstract

Background: The correlation between the Japanese version of high bleeding risk (J-HBR) criteria and the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score is unknown, as is the relationship of both risk scores with ischemic events.

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Cite This Study

Kubota et al. (2022) conducted an observational in Patients undergoing percutaneous coronary intervention (PCI) (n=842). J-HBR score ≥1.5 vs. J-HBR score <1.5 was evaluated on Major bleeding at 1 year (HR 3.81, 95% CI 1.43-10.15, p=0.007). A modified Japanese version of the High Bleeding Risk (J-HBR) score ≥1.5 significantly predicted major bleeding at 1 year (HR 3.81) without an increased risk of ischemic events.

synapsesocial.com/papers/6a958e184da1d0d027e3e225https://doi.org/10.1253/circrep.cr-22-0059
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