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Research Letter
June 2, 2021

Trade-Off Between Bleeding and Thrombotic Risk in Patients With Academic Research Consortium for High Bleeding Risk

Author Affiliations
  • 1Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
JAMA Cardiol. Published online June 2, 2021. doi:10.1001/jamacardio.2021.1558

Urban et al1 recently developed the Academic Research Consortium for high bleeding risk (ARC-HBR) trade-off model. The new scores provide the predicted 1-year risk of nonperiprocedural major bleeding (Bleeding Academic Research Consortium [BARC] types 3-5 bleeding) and thrombotic events (myocardial infarction [MI] and/or definite or probable stent thrombosis [ST]) after coronary stenting in patients with HBR. In the development and validation cohorts, the C statistics were 0.68 and 0.74 for major bleeding and 0.68 and 0.74 for thrombotic events, respectively; C statistics in validation cohorts typically are lower than those observed in the development cohort. To support individual optimal antiplatelet therapy, bleeding and thrombotic risk scores should achieve helpful discrimination (C statistics, ≥0.60) in contemporary treatment strategies.2 We applied the scores to the GLOBAL LEADERS trial population.3

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