Michael Gao, Alessandro Spirito, Samantha Sartori, Birgit Vogel, Mauro Gitto, Angelo Oliva, Kenneth F. Smith, Joseph Sweeny, Prakash Krishnan, Pedro Moreno, Parasuram Melarcode Krishnamoorthy, Annapoorna Kini, George Dangas, Samin K. Sharma, Roxana Mehran
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Sharma, Roxana Mehran","doi":"10.1002/ccd.31322","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Whether the high bleeding risk (HBR) criteria of the Academic Research Consortium (ARC) have a consistent predictive ability across different categories of body mass index (BMI) remains unclear.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Consecutive patients undergoing percutaneous coronary intervention (PCI) between 2012 and 2019 at Mount Sinai Hospital (New York, USA) were stratified into five BMI categories (18.5–24.9 kg/m<sup>2</sup> [normoweight], 25–29.9 kg/m<sup>2</sup> [overweight], 30–34.9 kg/m<sup>2</sup> [Class I obesity], 35–39.9 kg/m<sup>2</sup> [Class II obesity], and BMI ≥ 40 kg/m<sup>2</sup> [Class III obesity]) and by HBR status. The primary outcome was major bleeding at 1 year after PCI.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 16,123 patients, normoweight, overweight, class I, class II, and class III obesity were found in 23.7%, 41%, 24.5%, 9.3%, 4.8% of patients, respectively. Fulfillment of the ARC-HBR criteria ranged between 34.4% and 48.5% across these BMI categories. One-year rates of major bleeding was 6% in normoweight patients (reference), 4.1% in overweight (adj.HR 0.73, 95% CI 0.60–0.88), 3.5% in class I (adj.HR 0.62, 95% CI 0.49–0.77), 4.2% in class II (adj.HR 0.72, 95% CI 0.54–0.96), and 4.9% in class III (adj.HR 0.83, 95% CI 0.58–1.18) obesity. Consistently across the 5 BMI categories, the fulfillment of ARC-HBR criteria was related with > 4% rates of major bleeding at 1-year and with ≥ 2 times risk increase of major bleeding (<i>p</i><sub>int</sub> = 0.177).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The presence of the ARC-HBR criteria predicted a significantly increased risk of major bleeding consistently in each BMI category.</p>\n </section>\n </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 3","pages":"681-691"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive Ability of the Academic Research Consortium High Bleeding Risk Criteria in Patients Undergoing Percutaneous Coronary Intervention According to Body Mass Index\",\"authors\":\"Michael Gao, Alessandro Spirito, Samantha Sartori, Birgit Vogel, Mauro Gitto, Angelo Oliva, Kenneth F. 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引用次数: 0
摘要
背景：学术研究联盟（ARC）的高出血风险（HBR）标准是否在不同类别的体重指数（BMI）中具有一致的预测能力尚不清楚。方法：将2012 - 2019年在美国纽约西奈山医院连续接受经皮冠状动脉介入治疗（PCI）的患者分为5类BMI (18.5-24.9 kg/m2[正常体重]、25-29.9 kg/m2[超重]、30-34.9 kg/m2[ⅰ类肥胖]、35-39.9 kg/m2[ⅱ类肥胖]和BMI≥40 kg/m2[ⅲ类肥胖])，并按HBR状态进行分层。主要结局为PCI术后1年大出血。结果：在16123例患者中，体重正常、超重、I级、II级和III级肥胖分别占23.7%、41%、24.5%、9.3%、4.8%。在这些BMI类别中，ARC-HBR标准的完成率在34.4%到48.5%之间。正常体重患者一年大出血发生率为6%（参考），超重患者为4.1% (adj.HR 0.73, 95% CI 0.60-0.88)， I类肥胖患者为3.5% (adj.HR 0.62, 95% CI 0.49-0.77)， II类肥胖患者为4.2% (adj.HR 0.72, 95% CI 0.54-0.96)， III类肥胖患者为4.9% （adj.HR 0.83, 95% CI 0.58-1.18）。在5个BMI类别中，ARC-HBR标准的实现与1年大出血率的40.4%和大出血风险增加≥2倍相关（pint = 0.177）。结论：ARC-HBR标准的存在预测了每个BMI类别中大出血风险的显著增加。
Predictive Ability of the Academic Research Consortium High Bleeding Risk Criteria in Patients Undergoing Percutaneous Coronary Intervention According to Body Mass Index
Background
Whether the high bleeding risk (HBR) criteria of the Academic Research Consortium (ARC) have a consistent predictive ability across different categories of body mass index (BMI) remains unclear.
Methods
Consecutive patients undergoing percutaneous coronary intervention (PCI) between 2012 and 2019 at Mount Sinai Hospital (New York, USA) were stratified into five BMI categories (18.5–24.9 kg/m2 [normoweight], 25–29.9 kg/m2 [overweight], 30–34.9 kg/m2 [Class I obesity], 35–39.9 kg/m2 [Class II obesity], and BMI ≥ 40 kg/m2 [Class III obesity]) and by HBR status. The primary outcome was major bleeding at 1 year after PCI.
Results
Among 16,123 patients, normoweight, overweight, class I, class II, and class III obesity were found in 23.7%, 41%, 24.5%, 9.3%, 4.8% of patients, respectively. Fulfillment of the ARC-HBR criteria ranged between 34.4% and 48.5% across these BMI categories. One-year rates of major bleeding was 6% in normoweight patients (reference), 4.1% in overweight (adj.HR 0.73, 95% CI 0.60–0.88), 3.5% in class I (adj.HR 0.62, 95% CI 0.49–0.77), 4.2% in class II (adj.HR 0.72, 95% CI 0.54–0.96), and 4.9% in class III (adj.HR 0.83, 95% CI 0.58–1.18) obesity. Consistently across the 5 BMI categories, the fulfillment of ARC-HBR criteria was related with > 4% rates of major bleeding at 1-year and with ≥ 2 times risk increase of major bleeding (pint = 0.177).
Conclusions
The presence of the ARC-HBR criteria predicted a significantly increased risk of major bleeding consistently in each BMI category.
期刊介绍：
Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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