

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.

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.8 Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.7 Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky.6 Department of Cardiology, University of Leuven, Leuven, Belgium.5 Division of Cardiology, University of Alberta, Edmonton, Canada.4 Stanford University, Stanford, California.3 Duke Clinical Research Institute, Durham, North Carolina.2 Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.1 Hartcentrum Hasselt, Hasselt, Belgium.
