Inclusion of BARC (2, 3, or 4) bleeding in the 1-year mortality model with baseline characteristics improved it to an extent comparable to TIMI minor/major and GUSTO moderate/severe bleeding. BARC 4 bleeds were significantly associated with mortality within 30 days (hazard ratio: 10.05 95% confidence interval: 5.41 to 18.69 p < 0.0001), but not thereafter. The hazard of mortality increased progressively with non-CABG BARC grades. Patients with BARC (2, 3, or 4) bleeding had a significant increase in risk of death versus patients without bleeding (BARC 0 or 1) the hazard was highest in the 30 days after bleeding (hazard ratio: 7.35 95% confidence interval: 5.59 to 9.68 p < 0.0001) and remained significant up to 1 year. CABG-related bleeding (BARC 4) occurred in 155 (1.2%) patients. The main outcome measure was all-cause death.ĭuring follow-up (median: 502 days), noncoronary artery bypass graft (CABG) bleeding occurred in 1,998 (15.4%) patients according to BARC (grades 2, 3, or 5), 484 (3.7%) patients according to TIMI minor/major, and 514 (4.0%) patients according to GUSTO moderate/severe criteria. We analyzed bleeding in 12,944 patients with acute coronary syndromes without ST-segment elevation, with or without early invasive strategy. This study sought to investigate the relationship between BARC-classified bleeding and mortality and compared its prognostic value against 2 validated bleeding scales: TIMI (Thrombolysis In Myocardial Infarction) and GUSTO (Global Use of Strategies to Open Occluded Arteries). Validation in large cohorts of patients is needed. Electronic address: Bleeding Academic Research Consortium (BARC) scale has been proposed to standardize bleeding endpoint definitions and reporting in cardiovascular trials. 15 Duke Clinical Research Institute, Durham, North Carolina.14 Department of Coronary Artery Disease and Cardiac Catheterization Laboratory, Institute of Cardiology, Warsaw, Poland.13 Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.12 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria. 11 Internal Medicine and Cardiology, Universitätsklinikum, Freiburg, Germany.10 Department of Cardiology, Medisch Centrum Alkmaar, Alkmaar, the Netherlands.9 SAHMRI, Flinders University and Medical Centre, Adelaide, Australia.
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