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High bleeding risk

In keeping with previous ARC initiatives, this ARC-HBR definition addresses an unmet need by providing a framework for evaluating treatment options for patients undergoing PCI at increased bleeding risk. It is expected that consistent use of the consensus definitions will improve our ability to tailor treatment to individual patient needs and to stimulate scientific progress, innovation, and quality control initiatives. We therefore encourage trialists and trial sponsors to consider using ARC-HBR definitions in clinical studies with reporting of BARC 3 or 5 bleeding rates to allow comprehensive and consistent assessment of patients at HBR.

Note: paragraph extracted from ARC-HBR Part I, available through the link below.

ARC Publications

High Bleeding Risk Academic Research Consortium (ARC-HBR-1)

• Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk (ARC-HBR-1).
Reference: Eur Heart J. 2019 Aug 14;40(31):2632-2653.

• Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention (ARC-HBR-1).
Reference: Circulation. 2019 Jul 16;140(3):240-261.

High Bleeding Risk Academic Research Consortium 2 (ARC-HBR-2)

Trial Design Principles for Patients at High Bleeding Risk Undergoing PCI: JACC Scientific Expert Panel.
Reference: J Am Coll Cardiol 2020 Sep 22;76(12):1468-1483.

Association between the number of academic research consortium for high bleeding risk (ARC-HBR) criteria and clinical outcomes in patients with acute coronary syndrome.

Reference: J Cardiol. 2023 Jan 19:S0914-5087(23)00003-5.

Estimation of adverse events associated with P2Y12 receptor inhibitors stratified by academic research consortium for high bleeding risk criteria in acute coronary syndrome.

Reference: Int J Cardiol. 2023 Jan 14:S0167-5273(23)00061-X.

Validation of the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria in patients undergoing peripheral endovascular interventions.

Reference: EuroIntervention. 2022 Dec 29:EIJ-D-22-00475.

Performance of the Academic Research Consortium High Bleeding Risk Criteria in Patients With ST-Segment Elevation Myocardial Infarction: A Single Center Study.

Reference: Angiology. 2022 Oct 29:33197221135739.

ARC-HBR criteria and TAVR: not all high bleeding risk patients look alike.

Reference: EuroIntervention. 2022 Aug 19;18(6):448-449.

Academic Research Consortium High Bleeding Risk Criteria associated with 2-year bleeding events and mortality after transcatheter aortic valve replacement discharge: a Japanese Multicentre Prospective OCEAN-TAVI Registry Study.

Reference: Eur Heart J Open. 2021 Nov 15;1(3):oeab036.

Comparison of original and modified Academic Research Consortium for High Bleeding Risk definitions in real-world practice.

Reference: J Cardiol. 2022 Aug;80(2):155-161.

Temporal Trends of Major Bleeding and Its Prediction by the Academic Research Consortium-High Bleeding Risk Criteria in Acute Myocardial Infarction.

Reference: J Clin Med. 2022 Feb 14;11(4):988.

Ischemic and Bleeding Outcomes According to the Academic Research Consortium High Bleeding Risk Criteria in All Comers Treated by Percutaneous Coronary Interventions.

Reference: Front Cardiovasc Med. 2021 Dec 2;8:620354.

Validation of the Academic Research Consortium for High Bleeding Risk criteria in Chinese patients with atrial fibrillation and acute coronary syndrome or undergoing percutaneous coronary intervention.

Reference: Thromb Res. 2022 Jan;209:16-22.

Validation of the academic research consortium high bleeding risk criteria in patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis of 10 studies and 67,862 patients.

Reference: Int J Cardiol. 2022 Jan 15;347:8-15.

Simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) Definition Predicts Bleeding Events in Patients With Heart Failure.

Reference: Circ J. 2021 Dec 24;86(1):147-155. doi: 10.1253/circj.CJ-21-0686. Epub 2021 Oct 26.

Practical Assessment of the Tradeoff between Fatal Bleeding and Coronary Thrombotic Risks using the Academic Research Consortium for High Bleeding Risk Criteria.

Reference: J Atheroscler Thromb. 2022 Aug 1;29(8):1236-1248.

Sex-Related Differences in the Prevalence and Prognostic Value of the Academic Research Consortium for High Bleeding Risk Criteria.

Reference: Circ Cardiovasc Interv. 2021 Sep;14(9):e010392.

Performance of the academic research consortium high-bleeding risk criteria in patients undergoing PCI for acute myocardial infarction.

Reference: J Thromb Thrombolysis. 2022 Jan;53(1):20-29.

Assessment of the Academic Research Consortium for High Bleeding Risk Criteria in Patients Undergoing TAVR.

Reference: JACC Cardiovasc Interv. 2021 Jun 14;14(11):1265-1267.

Sex-Based Differences in Bleeding Risk After Percutaneous Coronary Intervention and Implications for the Academic Research Consortium High Bleeding Risk Criteria.

Reference: J Am Heart Assoc. 2021 Jun 15;10(12):e021965.

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

Reference: JAMA Cardiol. 2021 Sep 1;6(9):1092-1094.

Applicability of the Academic Research Consortium for High Bleeding Risk in acute coronary syndrome undergoing percutaneous coronary intervention.

Reference: Rev Esp Cardiol (Engl Ed). 2022 May;75(5):375-383.

Academic Research Consortium for High Bleeding Risk Definitions for Early, Late, and Very Late Bleeding Events.

Reference: Circ J. 2021 May 25;85(6):797-805.

Academic Research Consortium Definition of High Bleeding Risk in Clinical Practice - Validation and Beyond.

Reference: Circ J. 2021 May 25;85(6):806-807.

Assessing the Risks of Bleeding vs Thrombotic Events in Patients at High Bleeding Risk After Coronary Stent Implantation: The ARC-High Bleeding Risk Trade-off Model

Reference: JAMA Cardiol. 2021 Apr 1;6(4):410-419.

Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities.

Reference: Heart Vessels. 2021 Sep;36(9):1350-1358.

Bleeding events and mid-term mortality in the patients undergoing endovascular interventions for peripheral artery disease of the lower limbs based on the academic research consortium high bleeding risk criteria.

Reference: Heart Vessels. 2021 Sep;36(9):1336-1349.

Validation and Additive Predictive Value of the Academic Research Consortium-High Bleeding Risk Criteria in Older Adults.

Reference: Thromb Haemost. 2021 Sep;121(9):1255-1257.

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention.

Reference: Circ J. 2021 Jan 25;85(2):159-165.

Validation of high bleeding risk criteria and definition as proposed by the academic research consortium for high bleeding risk.

Reference: Eur Heart J. 2020 Oct 7;41(38):3743-3749.

Drug-coated stents versus bare metal stents in Academic Research Consortium-defined high bleeding risk patients.

Reference: EuroIntervention. 2021 Jun 25;17(3):240-247.

Prevalence of the Academic Research Consortium for High Bleeding Risk Criteria and Prognostic Value of a Simplified Definition.

Reference: Circ J. 2020 Aug 25;84(9):1560-1567.

Validation of the Academic Research Consortium Definition of High Bleeding Risk: Not Academic Anymore.

Reference: J Am Coll Cardiol. 2020 Jun 2;75(21):2723-2725.

Validation of the Academic Research Consortium High Bleeding Risk Definition in Contemporary PCI Patients.

Reference: J Am Coll Cardiol. 2020 Jun 2;75(21):2711-2722.

Validation of the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria in patients undergoing percutaneous coronary intervention and comparison with contemporary bleeding risk scores.

Reference: EuroIntervention. 2020 Aug 28;16(5):371-379.

Validation of Standardization: Testing the Academic Research Consortium High Bleeding Risk Criteria.

Reference: Circ Cardiovasc Interv. 2019 Nov;12(11):e008569.

Application of the Academic Research Consortium High Bleeding Risk Criteria in an All-Comers Registry of Percutaneous Coronary Intervention.

Reference: Circ Cardiovasc Interv. 2019 Nov;12(11):e008307.

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