Bleeding complications in ACS patients treated with antithrombotics and revascularization are independently associated with increased mortality and recurrent ischemic events, highlighting the critical need for bleeding risk stratification.
Supports bleeding risk stratification in ACS; leaves open whether mitigation strategies improve survival.
Progress in antithrombotic medications and revascularization procedures has helped to reduce mortality in patients with acute coronary syndromes (ACS). However, these therapies can significantly increase the risk of bleeding. Bleeding complications are important clinical outcomes in patients with ACS. Data from numerous randomized controlled trials and large registries have demonstrated that bleeding is independently associated with a significantly higher risk of mortality in patients with ACS. Furthermore, bleeding complications are associated with an increased risk of recurrent ischemic events. The challenge of preventing bleeding complications while obtaining the optimal antithrombotic benefits of ACS management requires careful consideration of factors associated with patients, pharmacotherapy, and interventional procedures. Clinicians should be able to risk stratify patients for bleeding events just as they would do for recurrent ischemic events in ACS.
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Amin et al. (2012) studied this question.
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