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.
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.
Valgimigli et al. (Mon,) studied this question.