การเปรียบเทียบภาวะแทรกซ้อนทางหลอดเลือดระหว่างกลุ่มผู้ป่วยที่มีความเสี่ยงต่อ ภาวะเลือดออกในระดับสูงและระดับต่ำ ซึ่งเข้ารับการทำหัตถการรักษา โรคหลอดเลือดแดงโคโรนารี ผ่านทางสายสวน

Pradtana Kunthum; Cattareeya Tanajug; Khunatpakorn Makkabphalanon

Authors

Pradtana Kunthum Cardiac care unit, Maharaj Nakorn Chiang Mai Hospital. Faculty of Medicine, Chiang Mai University.
Cattareeya Tanajug Cardiac Catheterization Laboratory, Maharaj Nakorn Chiang Mai Hospital. Faculty of Medicine,Chiang Mai University.
Khunatpakorn Makkabphalanon Boromarajonani College of Nursing, Nakhon Ratchasima

Keywords:

Percutaneous coronary intervention (PCI), High bleeding risk (ARC-HBR), Vascular complications, Major bleeding (BARC type 3 or 5), Coronary artery disease

Abstract

Vascular complications and major bleeding remain significant clinical concerns among patients undergoing percutaneous coronary intervention (PCI). Although the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria were developed to identify high-risk individuals, clinical data regarding its application in the Thai population remain limited.. This research aimed to evaluate the association between the ARC-HBR classification and the incidence of major bleeding (BARC type 3 or 5) and vascular complications following PCI in a Thai population. Methods: A single-center retrospective cohort study was conducted using medical records of 498 patients who underwent PCI between 2020 and 2022, with follow-up until October 31, 2024 (mean follow-up approximately 24 months). The ARC-HBR criteria were employed to stratify patients into high and low bleeding risk groups. Data were analyzed using the Chi-square test, Fisher's exact test, Independent t-test, Kaplan–Meier survival analysis with log-rank test, and univariable and multivariable logistic regression analyses.

Results: Patients classified as high bleeding risk according to the ARC-HBR criteria exhibited
a significantly higher incidence of major bleeding compared with those classified as low risk
(5.9% vs. 2.6%, p = .041). Vascular complications occurred more frequently in the high-risk group
(37.6% vs. 28.5%, p = .044). Multivariable logistic regression analysis identified age ≥75 years as an independent predictor of major bleeding (adjusted OR = 3.63; 95% CI: 1.41–9.30; p = .019).

Conclusions: The ARC-HBR criteria were associated with major bleeding and vascular complications following PCI in the Thai population. These findings may facilitate risk-stratified clinical decision-making and support the utilization of ARC-HBR as a pragmatic tool for individualized patient management and surveillance following PCI.

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