Academic Research Consortium for High Bleeding Risk (ARC-HBR) Criteria
Identifies patients undergoing percutaneous coronary intervention who are at high risk of major bleeding or intracranial hemorrhage.
Advice
- Use results alongside a thorough evaluation and specialist judgment.
- Bleeding risk may increase as more criteria are met; however, the tool is a binary classification, not a continuous risk score.
Management
- Meets criteria:
- Although bare-metal stents (BMS) were once preferred in high-bleeding-risk patients, drug-eluting stents (DES) are now favored in most cases.
- Plan an abbreviated dual antiplatelet therapy (DAPT) course (often 1–3 months), followed by single antiplatelet therapy.
- Monitor closely for evidence of bleeding
- Does not meet criteria:
- Use standard DAPT durations per cardiology guidelines (e.g., 6–12 months).
- Monitor for interval changes or evidence of bleeding.
Critical Actions
Always weigh bleeding risk against ischemic risk.