Key result
High bleeding risk by ARC-HBR criteria affects ~48% of patients hospitalized with suspected NSTEMI.
Why the study?
Recent ACS guidelines emphasize identifying high bleeding risk (HBR) patients, prompting investigation of the prevalence of ARC-HBR criteria among hospitalized patients with suspected NSTEMI.
Observational (n=212)
No
Nearly half of hospitalized patients with suspected NSTEMI meet ARC-HBR criteria for high bleeding risk, highlighting the need for comprehensive bleeding risk screening to guide management in this population.
May support bleeding risk screening in suspected NSTEMI; leaves open whether ARC-HBR integration improves outcomes.
In recent years, guidelines for the management of acute coronary syndromes (ACS) have placed more emphasis on identifying patients at high bleeding risk (HBR). We set out to investigate the prevalence of HBR patients according to the Academic Research Consortium for High Bleeding Risk (ARC–HBR) criteria in hospitalized patients with suspected non-ST-segment elevation myocardial infarction (NSTEMI). Consecutive patients were retrospectively enrolled between January and June 2019 from the emergency department (ED) of a tertiary hospital. The discharge diagnosis and baseline data were manually collected using electronic patient records and database searches. Patients with non-cardiac diagnoses were excluded. Overall, 212 patients were included in the study. A total of 146 (68.9%) patients were diagnosed with NSTEMI (Type 1), 47 (22.2%) with unstable angina pectoris (UAP) and 19 (9.0%) with “other.” HBR was detected in 47.6% (n = 101) of all patients. Common criteria for HBR among ACS patients were age (40.4%), chronic kidney disease (33.7%), and the use of oral anticoagulation medicines (20.2%). In conclusion, nearly half of the patients hospitalized for ACS fulfilled HBR criteria. According to contemporary guidelines, the management of HBR patients differs from that of non-HBR patients, and thus, a more comprehensive screening for HBR may be considered in clinical practice.
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Kesti et al. (2022) conducted an observational in Suspected NSTEMI (n=212). High bleeding risk according to ARC-HBR criteria was present in 47.6% of hospitalized patients with suspected NSTEMI.
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