ARC-HBR criteria identified 39% of AMI patients as high bleeding risk, predicting significantly higher 5-year risks of MACE (aHR 2.68-2.99) and major bleeding (aHR 2.28-2.71).
Do the ARC-HBR criteria predict major bleeding and ischaemic events in an all-comer AMI population?
In an all-comer AMI population, ARC-HBR criteria identify patients at significantly higher risk for both MACE and major bleeding events, regardless of medical or invasive management.
Abstract Background A significant proportion of patients with acute myocardial infarction (AMI) have characteristics of high-bleeding -risk (HBR). The prevalence of HBR features and whether these influence ischaemic and bleeding-events in AMI all-comers is not well described. Methods AMI Patients in England and Wales (E0.001). MACE was more likely in both medically-managed (E0.001), as were major-bleeding events in medical (E0.001) and invasive groups (E0.001), S: 1.41 1.29-1.54, P=0.024). Conclusions In an all-comer AMI population, 1 in 3 patients meet HBR criteria. HBR patients had significantly higher rates of MACE and major bleeding events, which persisted whether managed invasively or medically. We show that the ARC-HBR criteria are associated with increased bleeding and MACE risk in an all-comer AMI population.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Weight et al. (2026) studied this question. ARC-HBR criteria identified 39% of AMI patients as high bleeding risk, predicting significantly higher 5-year risks of MACE (aHR 2.68-2.99) and major bleeding (aHR 2.28-2.71).