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

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Abstract

The Academic Research Consortium (ARC) recently published a definition of patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention. However, the prevalence of the ARC-HBR criteria in patients undergoing endovascular therapy (EVT) for peripheral artery disease in lower extremities has not been thoroughly investigated. This study sought to investigate the prevalence and impact of the ARC-HBR criteria in patients undergoing EVT. We analyzed 277 consecutive patients who underwent their first EVT from July 2011 to September 2019. We applied the full ARC-HBR criteria to the study population. The primary end point was a composite outcome of all-cause mortality, Bleeding Academic Research Consortium 3 or 5 bleeding, and lower limb amputation within 12 months of EVT. Among the 277 patients, 193 (69.7%) met the ARC-HBR criteria. HBR patients had worse clinical outcomes compared with non-HBR patients at 12 months after EVT, including a higher incidence of the composite primary outcome (19.2% vs. 3.6%, p < 0.001) and all-cause death (7.8% vs. 0%, p = 0.007). In a multivariate Cox proportional hazards regression analysis, presence of the ARC-HBR criteria [hazard ratio (HR) 4.15, 95% confidence interval (CI) 1.25–13.80, p = 0.020], body mass index (HR 1.13, 95% CI 1.01–1.27, p = 0.042), diabetes mellitus (HR 2.70, 95% CI 1.28–5.69, p = 0.009), hyperlipidemia (HR 0.41, 95% CI 0.21–0.80, p = 0.009), and infrapopliteal lesions (HR 3.51, 95% CI 1.63–7.56, p = 0.001) were independent predictors of the primary composite outcome. Approximately 70% of Japanese patients undergoing EVT met the ARC-HBR criteria, and its presence was strongly associated with adverse outcomes within 12 months of EVT.

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Acknowledgements

We thank Hanne Gadeberg, PhD, and Emily Woodhouse, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Cardiology, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi, Japan

    Ryota Hashimoto, Yohei Numasawa, Souichi Yokokura, Kyohei Daigo, Shingo Sakata, Shohei Imaeda, Yasuhiro Hitomi, Kazuki Sato, Akira Taruoka, Sho Haginiwa, Hidenori Kojima, Makoto Tanaka, Toshiki Kuno & Masaki Kodaira

  2. Department of Cardiovascular Medicine, Dokkyo Medical University Hospital, Mibu, Japan

    Ryota Hashimoto

  3. Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA

    Toshiki Kuno

  4. Department of Cardiology, McGill University, Montreal, Canada

    Masaki Kodaira

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  1. Ryota Hashimoto
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Correspondence to Yohei Numasawa.

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Hashimoto, R., Numasawa, Y., Yokokura, S. et al. Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities. Heart Vessels 36, 1350–1358 (2021). https://doi.org/10.1007/s00380-021-01813-2

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