Key result
BARC 3b bleeding matches MI mortality risk in post-ACS patients, while BARC 3c exceeds it.
Why the study?
The relative impact of different types of myocardial infarction and bleeding on mortality after ACS treated with antiplatelet therapy was unclear.
How does the prognostic impact of different severities of bleeding (BARC criteria) compare to the impact of myocardial infarction on mortality in patients treated with antiplatelet therapy after ACS?
How does the prognostic impact of different severities of bleeding (BARC criteria) compare to the impact of myocardial infarction on mortality in patients treated with antiplatelet therapy after ACS?
In post-ACS patients on antiplatelet therapy, severe bleeding (BARC 3b and 3c) carries a mortality risk equivalent to or greater than that of a subsequent myocardial infarction.
Answers are grounded in this paper and cite their sources.
Severe BARC 3b/3c bleeding signals mortality risk comparable to MI post-ACS; extends BARC validation but leaves open whether bleeding reduction improves survival.
In patients treated with antiplatelet therapy after ACS, both MI and bleeding significantly impacted mortality with similar time-dependency. Although BARC 2 and 3a bleeding were less prognostic for death than MI, the risk of mortality was equivalent between BARC 3b bleeding and MI, and was higher following BARC 3c bleeding.
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Valgimigli et al. (2016) studied this question. BARC 3b bleeding had a mortality risk equivalent to myocardial infarction, while BARC 3c bleeding had a higher mortality risk than MI in post-ACS patients on antiplatelet therapy.
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